Micronized fat injections can be used for facial rejuvenation, volumizing the face and hands and to regenerate and stimulate new hair growth.

1. What is new with Fat grafting to the face and hands at the Aesthetic Laser
Center?
What is new is called autologous lipocyte micronized injections. This is a fancy term
that describes what we do to the fat after it is harvested before I graft it to the face,
hands or scalp for hair restoration.
Previously, I harvested the fat from patients and centrifuged the fat to further purify it
and remove the excess oil and fluid. What was left was mature fat cells and a small
important portion called Stromal Vascular Fraction or SVF.
The SVF contains fibroblast, endothelial cells, pre-adipoctyes (cells that will turn into
adipocytes or fat cells), smooth muscle cells, lymphocytes, macrophages and adipose
derived stem cells.
There have been numerous studies in the literature documenting the use of SVF to be
effective in regenerative medicine.
The problem with SVF is that it is expensive to obtain and it needs to be enzymatically
prepared.
The fat after it is harvested can be mechanically micronized and placed through a filter
that removes the adult fat cells. What is left, contains most of the cells in the Stromal
Vascular Fraction or SVF. This is also called autologous cellular matrix or ACM and it is
very watery compared to the fat that I used to graft. What is nice is that it can be
injected with a small needle or 25 gauge cannula that I use to inject fillers.
Extrinsic photo-aging and chronological intrinsic aging occurs in our skin. UV exposure
causes changes of epidermal thinning along with decreased fibroblast activity and
irregularly arranged elastin fibers. The results are wrinkles, dryness, laxity due to
decrease elasticity, and irregular pigmentation. Studies have shown an increase in
collagen production in the dermis along with increased vascularity when SVF is injected
into the skin.
A study by Amirkhani, et al 1
showed that after the skin was injected with SVF, it caused
the dermis to be thicker and there was more vessels produced which caused a
rejuvenation of the skin. They also observed that water evaporation of the skin was also
decreased which made the skin look plumper and less dry.
I like to treat the epidermis also when I inject the micronized fat. I will usually do a
Dermapen on the patient at the same time. I like to glide the Dermapen with the
micronized fat, which produces channels in the skin and thus introduces the material
that has the stem cells and other cells needed for rejuvenation into the dermis. This has
the effect of thickening the epidermis which does not occur when you inject the
micronized fat in the dermis or subcutaneous tissue. Patients also get nice skin
tightening when a Dermapen is performed at the same time.
The injected material has a volumizing effect and rejuvenating effect just like when I
used to inject fat. What I have noticed is that there is much less swelling probably
because the injected adult fat cells would die within 72 hrs. and would have to be
naturally removed by the body’s own immune mechanisms.

2. A study by Rigotti, et al 2
showed that adding PRP did not improve the skin over using
adipose-derived stem cells or SVF-enriched fat. The PRP produced a greater vascular
reactivity which was not needed for simple rejuvenation of the skin. It might be more
useful in regenerative medicine where more new and existing blood vessel formation if
needed such as in healing chronic ulcer wounds.
Before and after micronized injections to the face along with a Dermapen
treatment. Injections to tear troughs, temporals, lips.
Before and after micronized injections into hands along with a Dermapen treatment.

3. The following
are
examples of
patients
that
had
micronized fat
injections
using
a
25g
cannula or
27g needle and a
Dermapen at the
same time.
References:
1. Amirkhani, et al. Rejuvenation
of facial skin and improvement in the
dermal architecture by transplantation of
autologous stromal vascular fraction in a clinical study. Bioimpacts. 2016, 6(3): 149-
154.
Before and after micronized injections into the Tear Troughs, Temporals along with Dermapen
treatment of face and neck. Notice the skin tightening in neck.

4. 2. Ribotti, G., et al. Expanded Stem Cells, Stromal-Vascular Fraction, and Platelet-Rich
Plasma Enriched Fat: Comparing Results of Different Facial Rejuvenation
Approaches in a Clinical Trial. Aesthetic Surg. J. 2016 Mar;36(3):261-70.