At the end of the 1980's and at the beginning of the 1990's, free fat autografts were abandoned because of the poor long-term results. Two theories supported by hystological studies (the host replacement theory or the cell survival theory) have now been proposed to explain survival of fat tissue. They demonstrate that, when harvested by a correct technique, fat tissue presents the ideal characteristics to be grafted, providing a good soft-tissue substitute with a minimum follow-up of four years up to 6 years. The authors present a multiple stage lipofilling technique in 99 cases of facial rejuvenation by means of lipolayering. Injections are performed every 20 days and fat is stored fat at -30°C with good aesthetic results and minimal morbidity with clinical follow-up at 4 and 6 years. Histological examination of fat stored for 20 days and for 8 months was also performed in 10 patients. Microscopic and ultrastructural examination demonstrated that stored adipocytes retain their anatomical features and, when injected in multiple stages, are adequate to obtain good clinical results. Our histological study combined with the clinical outcomes, suggests the advantage of several stage injection of stored fat (-30°C). (C) 2000 Editions scientifiques et medicales Elsevier SAS.
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