Lipofilling With Minimal Access Cranial Suspension Lifting for Enhanced Rejuvenation

Background: Loss of volume is an important aspect in facial aging, but its relevance is frequently neglected during treatment. Objectives: The authors discuss lipofilling as an ancillary procedure to improve the impact of facelifting procedures. Methods: Fifty patients who underwent minimal access cranial suspension (MACS) lifting alone were retrospectively analyzed, and their results were compared to 42 retrospective cases of MACS lifting with adjuvant lipofilling. The results were evaluated with a photographic ranking system by two panels (five plastic surgeons and five medical students). Results: Combined MACS lifting and lipofilling yielded overall cosmetic results that were significantly better than the results achieved with MACS lifting alone. Photographic evaluations showed that improvements were more pronounced in the tear trough (P<.05) and malar eminence (P<.01) than in the nasolabial groove (P>.05). Conclusions: Volume restoration with lipofilling following MACS lifting procedures produces significantly better postoperative results than MACS lifting alone. This combined procedure produces the most dramatic improvements in the tear trough and malar eminence regions.