Intraoral Approach to Fat Grafting Based on the Mimetic Muscle Unit

Abstract

Background: 

Recently, the concepts of anatomic-based fat grafting and mid-facial anatomy have been studied. However, there is no clear consensus on the optimal fat grafting technique. We aimed to introduce a novel intraoral approach to fat grafting based on mid-facial mimetic muscles, wherein a substantial amount of fat was injected into appropriate locations to increase patient satisfaction and decrease the need for additional surgical techniques.

Methods: 

Sixty-four Asian women (mean age, 41.2 y) who had undergone fat grafting through the intraoral approach between 2014 and 2019 were enrolled. We sequentially performed the following steps: fat harvesting, centrifugation, and fat injection. All patients were followed at an outpatient clinic for 6 to 12 months. We obtained photographs of their face before and at 3 and 6 months postoperatively and conducted a 5-point scale questionnaire survey at the 2 time points postoperatively to evaluate the satisfaction of patients and surgeons. We divided the mid-facial areas into malar eminence, infraorbital, and nasolabial fold areas and evaluated the following items: volume consistency, softness, irregularity, and overall satisfaction.

Results: 

Patients reported “satisfactory” for the postoperative results. There were only 2 cases of complication among the 64 cases which resolved spontaneously. The highest and lowest satisfaction were reported for the malar eminence and nasolabial fold areas, respectively.

Conclusions: 

Fat grafting through the intraoral approach based on the mimetic muscle unit is an effective and safe method for mid-facial rejuvenation.