FAMI™ Fat (Adult Stem Cells) history and technical information.

“Safer rejuvenation with systematized pan-facial anatomic muscle injection”

The use of autologous fat has been advocated for tissue augmentation for over a century. Autologous fat injection has become increasingly popular in the nineties, as an option for those patients who desire rejuvenation with facial volume enhancement. However, this technique remained controversial and many researchers have made suggestions to increase its potential.

In 1995, Lipostructure® represented an important advancement in plastic surgery, however, the high percentage of fat resorption and the resulting need for additional grafting considerably reduced the value of this method.

In 1996, after 14 years of performing traditional fat grafting, Dr. Roger Amar arrived at the conclusion, in accordance with the scientific literature, that the survival of fat transplants depended mainly on the vascularity of the host tissue and less on harvesting and reinjection methods.

The 30 muscles of facial expression and the periosteum were found to be the best recipient sites to optimize the results with a drastically increase chance of quality revascularization for the tissue transplant. From the beginning, Dr. Amar’s technique focused more on the necessity of a tissue transfer into or behind the three planes of facial musculature and under the periosteum of the skull.

The fatty tissue was collected from specific donor sites following peripheral tumescent infiltration. A multispeed centrifuge helped to purify the graft and to concentrate the lipoaspirate with adult stem cells or pre-adipocytes (mesenchymal multipotent cells).

Following this advancement, 418 patients were treated with this procedure, including plastic reconstructive and aesthetic indications. Follow up periods ranged from January 1997 to September 2005.

Outcome was considered satisfactory when the patient and the surgeon were pleased with the long-term results at the final evaluation. After 45-60 days, the transplants were stabilized and remained for the length of our study (up to 9 years in 2005).

Though patients were fully aware of a theoretical risk of redoing the procedure, they never experienced any touch up; many time an additional FAMI™ procedure (full face for symmetry) was proposed and done during up to nine years later.

The rejuvenation obtained with a “normal look” contrasts with the “mask look” often associated with invasive procedures such as face-lifting, frontal lift, blepharoplasty or extensive use of chemodenervation (Botox) or other artificial fillers.

By restoring the contour, shape and function of the 30 muscles of facial expression, the FAMI™ procedure proves to be a gratifyingly effective tool in the hands of a trained surgeon.

Dr. Roger E. Amar