Volume and patient satisfaction, 5 years of follow up after facial fat grafting

Abstract

Background: Autologous facial fat grafting is used to restore volume loss in the facial region. The volume retention after grafting is not stable over time. Objectives: The aim of this study was to assess long-term visible volume retention measured with 3-dimensional surface imaging and long-term patient-reported satisfaction 5 years after facial fat grafting. Methods: Twelve patients were included for 3-dimensional analysis and satisfaction measurements with 5 years of follow-up. Volume was measured with a validated automatic algorithm using three-dimensional surface imaging and patient satisfaction was recorded with the FACE-Q questionnaire. Results: After 5 years, the face volume increase was associated with the weight gain of the person and not with the injected volume. Weight gain beta (95% confidence interval) = 1.40 (0.37; 2.42), p = 0.013. Injected volume beta (95% confidence interval) = 0.30 (−0.28; 0.88), p = 0.268. Satisfaction returned to pre-operative levels (facial appearance score pre-operative) median 45.0 (IQR 25.5; 47.3); after 5 years median 39.0 (IQR 28.0; 57.0). Conclusion: After 5 years of facial fat grafting, volume retention was related to weight gain. Patient satisfaction returned to pre-operative levels. An increase in volume due to weight gain does not lead to increased patient satisfaction. Repeated fat grafting is necessary which will potentially increase satisfaction in the long term. Weight change as a confounder complicates long-term studies of volume retention.