Overview
Fat grafting is often added to a facelift to replace volume lost with age, but fat survival varies and volume can keep falling after surgery. The authors asked whether poly-L-lactic acid (PLLA), an injectable that stimulates the body to build volume, is safe for maintaining volume after facelift. They reviewed all of one surgeon's patients from 2010 to 2018 who had facelift with fat grafting and PLLA injections.
Findings
- 241 patients had facelift with fat grafting and PLLA injections, 2010 to 2018, one surgeon.
- 190 patients received PLLA after facelift and fat grafting; 51 received PLLA before the operation.
- The authors report 5 common reasons for PLLA after surgery. The abstract lists: unexplained early fat graft loss, significant weight loss after surgery, normal aging, and high lean body mass around the time of surgery.
- PLLA was also used to add volume to areas not fat grafted at the first operation.
- No complications from PLLA were reported related to nodules, papules or granulomas.
What it means for a patient
- Fat grafted during a facelift does not always survive in a predictable amount. Some volume may be lost in the months after surgery.
- Weight loss after surgery, normal aging, and a lean build were among the reasons patients needed more volume.
- PLLA injections were one option this surgeon used to restore volume later, without the nodule problems reported in this series.
- This is a retrospective review from one practice without a comparison group or measured volume change in the abstract.
Why this paper matters
It describes when one surgeon added PLLA after facelift with fat grafting and reports no nodule or granuloma complications in 241 patients. The authors present PLLA as a way to manage the variable survival of fat grafts.
Terms
- Poly-L-lactic acid (PLLA): an injectable material that prompts the skin to make collagen, adding volume over time.
- Biostimulator: a filler that works by causing the body to build its own tissue.
- Fat grafting: moving fat from one part of the body to the face by injection.
- Nodule: a small firm lump under the skin.
- Papule: a small raised bump on the skin.
- Granuloma: a lump formed by the body's reaction to a foreign material.
- Lean body mass: body weight that is not fat.