Nanofat in Plastic Reconstructive, Regenerative, and Aesthetic Surgery: A Review of Advancements in Face-Focused Applications

Abstract

Nanofat is a relatively novel technique in fat grafting that has gained significant interest in the fields of regenerative medicine, aesthetic and translational research. It involves the extraction of autologous fat from a patient, which is then transformed into "nanofat", consisting of small fat particles with a diameter of less than 0.1 mm and containing high concentrations of stem cells and growth factors. This article focuses on the use of nanofat in facial rejuvenation and its potential for lipomodelling. Fat tissue is a "stem cell depot" and nanofat contains many stem cells that can differentiate into various cell types. The Lipogem technology, developed in 2013, enables the isolation of nanofat with an intact perivascular structure, utilizing the high concentration of mesenchymal stromal cells near the pericytes of the adipose vascular system. Nowadays nanofat is used primarily for cosmetic purposes particularly in rejuvenating and improving the appearance of the skin, especially the face. Indeed, it has wide applicability; it can be used to treat fine lines, wrinkles, acne scars, sun-damaged skin, scar repair, and as an alopecia treatment. However, further studies are needed to assess the long-term efficacy and safety of this technique. In conclusion, nanofat is a safe and minimally invasive option for tissue regeneration with considerable therapeutic potential. This study reviews the application and effects of nanofat in regenerative medicine and facial cosmetic surgery.

Keywords: a review; facial rejuvenation; fat graft; lipomodelling; nanofat; regenerative medicine; stromal vascular tissue.

Figure 1

This picture shows how adipose tissue is mechanically emulsified to obtain nanofat by the authors’ method.

Figure 2

Flowchart.

Figure 3

Schematic representation of our method for obtaining nanofat using the Tulip system. Adipose tissue is harvested using a cannula with a 1 mm hole attached to a Luer-lock syringe (a). The adipose tissue is then passed back and forth 30 times between two 10 cc syringes connected by a Luer-lock connector, with diameters of 2.4 mm and 1.4 mm, respectively (b,c). Finally, a single pass is made through a nanofilter (d). The resulting emulsion can be infiltrated using 30-gauge needles (e).

Figure 4

A 53-year-old patient approached us to correct facial fine lines (a). An amount of 5 cc of nanofat (obtained from adipose tissue harvested from the hips under local anesthesia) were injected. No anesthesia was used for the facial injections. After one year of treatment, an improvement in wrinkles can be observed (b), and the patient was highly satisfied.