Lipofilling after Laser-Assisted Treatment for Facial Filler Complication: Volumetric and Regenerative Effect

We read with great interest the article entitled “Lipofilling after Laser-Assisted Treatment for Facial Filler Complication: Volumetric and Regenerative Effect,” by De Santis et al.1 The authors conducted a retrospective study of 33 patients to assess the efficacy of laser and lipofilling in the treatment of facial asymmetry and depression caused by inflammation of the permanent injectable filler. The authors confirmed the volumetric and regenerative effect of their treatment. In the authors’ practice, fat was collected using a 2-mm diameter cannula with 1-mm holes, and then fat graft was placed in the intradermal, subdermal layers and a deeper layer to correct superficial irregularities and restore volume, respectively. Cohen et al.2 recommended millifat (harvest cannula with 2.4-mm holes) for injections in the deep layer due to its structural integrity. Consistent with the authors’ practice, they believed that microfat is suitable for superficial grafting because it is not inclined to form a loculated mass beneath the skin.2 However, characteristics such as their surface area and the layer of lipofilling are different, which might result in different outcomes in the recipient area. Further study is warranted to determine which kinds of fat particles are suitable for different layers. The authors mentioned that it usually takes up to 4 months for a fat graft to fully stabilize, but it has been reported that 6 months or even years are needed for a final outcome.3 It remains to be investigated to provide clearer information on whether refilling before the eventual reabsorption affects the final fat retention. DISCLOSURE The authors have no financial interest to declare in relation to the content of this communication.