Lipofilling, micro-lipofilling, nano-lipofilling: what are the differences?

What is lipofilling?

Lipofilling, as its name suggests, uses fat to make up for the loss of facial volume. The technique was developed in the 1990s by Dr Sydney Coleman, an American oculoplastic surgeon.

I trained in this technique early on and have refined it over the years. For example, I chose to use very fine cannulas, also known as micro-cannulas, to give the injections, so as to minimise trauma at the entry points. I call this new technique micro-lipofilling, after the cannulas I use.

During the procedure, I begin by taking a small amount of fat from the abdomen, the knees or the thighs with a cannula of the kind used in liposuction. The fat is then filtered and stripped of its fibres, so as to keep only the finest, highest-quality fat cells, or adipocytes. These cells are then injected according to the patient’s particular needs.

Each area must be injected precisely and in measured amounts, so as to fill it without any risk of overcorrection.

The main indications for lipofilling are:

• Filling the under-eye circles, temples, cheeks, cheekbones and upper eyelids
• Filling wrinkles (nasolabial folds, the contours of the mouth, crow’s feet, glabellar lines)

I usually combine this technique with a facelift or a blepharoplasty (eyelid surgery) to achieve an overall facial rejuvenation.

A new technique: nano-lipofilling

Nano-lipofilling involves injecting stem cells and growth factors extracted from the patient’s own fat. Unlike conventional lipofilling, this technique does not aim to fill volumes but to regenerate the dermis, in order to improve the quality, radiance and texture of the skin. Patients see a reduction in the appearance of wrinkles, skin blemishes and scars.

Nano-lipofilling is also the only reliable and effective solution for treating dark circles. This discolouration is mainly due to the thinness of the skin in this area, which lets the vessels of the orbicularis muscle show through. Nano-lipofilling therefore thickens the skin and reduces this transparency.

Clinical trials are currently under way to measure the range of possible uses for nano-lipofilling. It could, for example, be used for genuine hair restoration in the treatment of baldness, thanks to its ability to stimulate hair regrowth, or in gynaecological aesthetics, to regenerate the vulvovaginal area.

The injection technique is similar to mesotherapy, with injections given into the superficial dermis. However, whereas mesotherapy relies on injecting a synthetic product, hyaluronic acid, nano-lipofilling introduces no foreign body into the patient. There is therefore a very limited risk of rejection or allergic reaction.

In conclusion

In my view, lipofilling, micro-lipofilling and nano-lipofilling represent the future of eyelid and oculoplastic surgery and of the treatment of facial ageing. It is no longer a question of pulling the skin to erase wrinkles, but of filling lost volume with natural material. Using fat cells also makes it possible to regenerate the skin and improve its intrinsic quality.

Depending on your needs, I will guide you towards one or other of these techniques, for a deep, overall rejuvenation of your face.