Abstract
Lipofilling, the transplantation of adipose tissue, has already been used since the
end of the 19th century. For decades, lipofilling was used to restore loss of volume
due to aging, trauma, or congenital defects. Later on, the indications for the use
of lipofilling expanded by treating aged skin, scars, and improving wound healing.
The expansion was caused by the discovery of adipose derived stromal cells (ASCs)
in adipose tissue and the development of very fine harvesting and injection cannulas
which made it possible to inject small adipose tissue particles in small volume areas,
such as the face. ASCs are multipotent stromal cells which reside in the stromal vascular
fraction (SVF) of adipose tissue and are able to differentiate in multiple cell lineages
and secrete a plurality of growth factors with regenerative potentials. The discovery
of ASCs led toward more experimental cell-based therapies, that is, ASCs or SVF isolated
by means of enzymatic isolation procedures. Later on, enzymatic isolation procedures
were forbidden in many countries by legislation and were replaced by mechanical isolation
procedures, such as the Nanofat and Fractionation of Adipose Tissue (FAT) procedures.
The Nanofat procedure has been extensively investigated, especially as treatment for
skin rejuvenation in the face. Though, substantial evidence is lacking for using facial
lipofilling or any therapeutic component, that is, ASCs or SVF for skin rejuvenation
to date. In contrast, facial lipofilling to restore loss of volume seems to be promising.
Keywords
lipofiling - lipografting - fat grafting - facial-skin rejuvenation - mesenchymal
stem cells - adipose-derived stromal cells - adipose tissue - skin quality - volume
enhancing - stromal vascular fraction - cell-assisted lipotransfer
