BACKGROUND: Although several methods of fat grafting have been reported, there is no agreement regarding which technique should be used for autologous fat grafting and the final outcome after fat grafting often depends on the technique used by a surgeon. In this report we present an integrated fat grafting technique developed over the years for cosmetic facial contouring. METHOD: Fat grafts were harvested under low pressure with syringes, processed with low speed centrifugation, and then injected into the affected areas of the face with low volume for each pass via multi-tunnels, multi-planes, and multi-points. We describe the above integrated fat grafting technique as '3Ls and 3Ms' technique. A total of 83 patients with temporal, cheek, and periocular hollowing, lean or aging face or facial asymmetry were injected with autologous fats between 1 and 3 times at interval of 3 to 6 months. All patients were evaluated clinically and followed up to 8 years. RESULTS: The absorption was found variable in different patients. Long-term follow-up proved that final correction after 1-3 injections of autologous fat had persisted for many years. Obviously improved facial contour was evident in most patients after autologous fat transplantations. More than 73.5% of the patients in this series were assessed as satisfactory by all 3 observers (patient, surgeon, and layerperson). Between 12.0% and 21.7% of the patients were mostly satisfactory. Less than 4.8% of the patients were unsatisfactory. CONCLUSIONS: Autologous fat grafting to the face is a safe and reliable option to improve facial contour in patients. The transplanted fat can survive well in the face with our integrated fat grafting technique. More than one injection may be required to achieve optimal outcome.
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