Facial aging presents a challenging problem for plastic and aesthetic surgeons; it is a multi factorial, multistep process that involves structural and volumetric changes in the skin, muscles, skeleton, and adipose tissue. Facial tissue descent is caused not only by gravity, but also by the reabsorption and repositioning of the facial adipose system. Facial rejuvenation with autologous fat has the advantage of replacing or augmenting tissue with like tissue. Autologous fat transplantation to the face can correct cosmetic defects that are caused by loss of subcutaneous tissue, such as atrophy of the face due to significant weight loss, wrinkles and facial involution due to aging.
The adult skeleton possesses 2 types of bone marrow: yellow and red. Yellow marrow has undergone adipose involution and is inactive. The red marrow possesses hematopoietic cells as well as 2 known populations of adult stem cells.1 Hematopoietic stem cells give rise to all cell components of circulating blood, such as erythrocytes, lymphocytes, neutrophils, and thrombocytes. The other stem cell population consists of mesenchymal stem cells (MSCs), which are also known as marrow stromal cells. MSCs have the potential to differentiate into connective tissue cells such as osteoblasts, osteocytes, adipocytes, and chondrocytes.