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Aesthetics Journal
Aesthetics
Illouz reinjection of raw material, in the French publication Annals of Plastic Surgery in 1999. I emphasised the importance of the instrumentation and the underlying anatomy to prevent the main complications of the Coleman technique, which include the unpredictability associated with painful bruising and the necessity of additional graft sessions to touch up the inconclusive outcomes.5
The FAMI technique
Case Study: Male Facial Rejuvenation Mr Roger Amar presents a case study of a male patient who was successfully treated using his facial autologous muscle injection fat transfer/ stem cell procedure As we age, many patients choose to undergo aesthetic treatments to address facial wrinkles and folds. Regularly, these patients opt for hyaluronic acid filler injections and, while they do often offer successful results, their benefits are temporary. It’s therefore often necessary for patients to come back to the needle, again and again. Fat transfer, on the other hand, can offer permanent solutions without the downtime associated with traditional plastic surgery. The first report on autologous fat grafting was published in 1893 by Neuber,1 who described implantation of small quantities of adipose tissue to correct adherent scars from
osteomyelitis. The technique continued to be widely utilised in plastic and reconstructive procedures to augment breasts and for the correction of chin and nose deformities. However, it was the advent of liposuction in the 1980s that opened new horizons for autologous fat transplantation. French plastic surgeon Mr Yves Gerard Illouz, who invented the mechanical liposuction, first described the reinjection of non-purified fat into other parts of the body in 1983.2 A few years later, French plastic surgeon Mr Pierre Fournier proposed the syringe liposuction technique and reinjection of the aspirated fat in the face using the same simple syringe.3 Fat transfer techniques became very popular in the medical Frontal fat pad world in 1995 when New York surgeon, Sydney R Coleman, Temporal fat pad released two harvesting Eyebrow position Luer-Lok cannulas (non-leaking cannulas), a small electrical lab Eyelids centrifuge and two injecting Levator Luer-Lok cannulas to make fat transfer easier.4 After building Labii superiors experience in each of the techniques, I wrote on the Malar eminence advantages of Coleman’s purification of fat before Figure 1: Pre-procedural planning of the patient showing areas that will benefit from the procedure. injection, over the Fournier and
To overcome the disadvantages associated with the Coleman system, in 1998, I introduced the idea of putting purified graft closer to, or inside tissue with maximum vascularity; the red muscles.5
The FAMI technique targets the individual muscles of facial expression, from their bone origin, to engraft the mesenchymal cells with the help of curved cannulas, which duplicate the skull curvatures The graft is placed behind or inside flat muscles or the round red mimic muscles. Mesenchymal tissues in contact with highly vascularised tissues immediately develop a neo-vascularity that guarantees the graft retention, which is the benefit. This was the beginning of the Facial Autologous Muscular Injection (FAMI) technique. In 2001, biologist Patricia Zuk from the University of California, Los Angeles, isolated the mesenchymal stem cells (MSCs) from adipose tissue and called them ‘adipose-derived stem/stromal cells’ or ‘ADSCs’. She stated that mesenchymal stem cells from fat have the same properties as embryonic stem cells. With this
Reproduced from Aesthetics | Volume 5/Issue 3 - February 2018