Frequently Asked Questions

In the nineties FAMI stood for Fat Auto grafting Muscle Injection.

After 2000 the fat from syringe liposuction was processed to obtain more adult stem cells to be used for pan-facial restoration. Now the acronym FAMI stands for Fresh Autologous Mesenchymal Integration.

Dr. Amar's insight was to place the fat autograft into the muscles of the face using specialized cannulae shaped to the contours of the face, as opposed to just under the skin as common fat grafting does. By placing the fat and mesenchymal stem cells into the rich vascular bed of the muscles, their chances of survival are enhanced. By using a person's own facial muscles as the model for graft placement, a person's natural appearance is preserved - you don't end up looking like you never did, as sometimes happens with "cut and pull" facelifting techniques.

FAMI is a US patented exclusive procedure which uses specific cannulae to place the autografts of pre-adipocytes or ADULT STEM CELLS into the muscle bed and under the Periosteum near the facial vessels.

FAMI restores Bone - Muscles - Fat Pads and skin in one session! Touching up is not the rule.

FAMI is now the most advanced mesenchymal tissue transfer procedure, because it offers the best present solution to the very old problem of transplanted fat survival.

Fat grafting has been used by Dr. Roger E. Amar since 1985. After more than 5000 muscle injections from 1996 to 2010, and after 9 years' follow up, Dr. Amar maintains without any doubt, that FAMI gives long lasting successful and symmetrical results. The rejuvenation process doesn't stop since the transplanted adult stem cells keep their properties. The restoration last virtually indefinitely. Why? Because Dr Roger Amar has been doing Full Face FAMI for 9 years and less than 10 in the follow up asked yet to have it redone!

Fat is a natural filler advocated by thousands of doctors for more than a century.

The safest grafts are the auto-grafts, which mean that the patient is grafted with its own tissues.

Over the last century, in medical meetings, the controversy has always been on the survival of the tissue, not on the safety of autografting. Since 2000 we have used a high speed centrifuge to destroy the large fat lobules and to concentrate the lipoaspirate with ADIPOSE STEM PROGENITOR CELLS.

These ADULT STEM CELLS have the same mesenchymal multipotent functions as the embryonic stem cells without the ethical controversial environment. The ADIPOSE STEM PROGENITOR CELLS from lower body are used to stimulate and/or restore bone surfaces, muscle fibers and fat cells when injected under the periosteum, into the muscles or into atrophied fat pads.

Yes, much safer. There is no possible comparison between a non-invasive injection technique and an open surgical technique with the risk of damaging nerves, arteries, veins and other important structures of the face. The AMAR specific blunt instrumentation for placement is the least traumatic tool for facial rejuvenation; the cannulae are adapted to the skull.

Before intervention the Doctor analyses some photos of the patients in their twenties to evaluate the modifications.

Lines and volumes are noticed. Shape of the brows, cheek bones, Temporal hollows, lips, jaws and chin are studied in order to restore them.

In our series the age of the patients ranges from 22 to 87. Any patient with an alteration due to age, accident or birth defect can benefit from the FAMI Technique. Nowadays many people, using diet and exercice, age with a thinner face. Lost of bone surfaces and shrinkage of the muscles are the primary manifestation of aging. In these patients rhytidectomy of facelift produces "a mask look"

Restoring the bone surfaces and the shape of the atrophied muscles with living tissues is the technique that we have developed for rejuvenation.

All patients with gaunt and drawn face, who are looking for rejuvenation without invasive surgery can benefit from FAMI.

Botox works by blocking impulses from the nerves to facial muscles.

Botox causes a paralysis of the facial muscles so they are unable to contract. If this injection is repeated, the underlying muscles become atrophied and this region of the face ages more rapidly.

In some case of strong muscle contractures BOTOX is used before the FAMI procedure to ensure a still face so that the implanted mesenchymal tissues will not move before they are integrated into the body.

FAMI, unlike standard face-lifting, has been shown to be a very safe procedure with uneventful follow up in the hands of doctors specifically trained in this procedure. The utilisation of superficial skin puncture with a blunt cannula is much more safer than any sharp needle or scalpel!

As a non-invasive surgical technique, FAMI is performed under local block anesthesia with Sedation in outpatient facilities.

After FAMI, the bruising is in generally insignificant or isolated to the areas around the mouth if the patient spoke a lot in the 2 days following the procedure. It can be easily hidden by a good coverage. The edema lasts for 10 days. Most patients are performing routine duties after 2 or 3 days, and public / professional contact 10 days.The downtime is variable, from 2 or 3 days for men to one week on women after 60.

Many patients are so excited by the result of the first procedure in the lower face or the upper face that they elect to have the other facial region treated in a subsequent session after 3 months.

After a Full Face FAMI, patients who have requested more rejuvenation effect could have a new Full Face FAMI one year after the first FAMI .

Just after the edema period of 2 weeks, the patient and relatives notice the natural rejuvenation which will continue to improve every day up to nine years in our series.

In general, body weight may remain the same if diet and exercise levels remain unchanged. The old rule that the face is the first area to be marked by weight loss will no longer exist. A normal diet after FAMI will be the best "facial" maintenance and if some weight is gaining the rejuvenation will be reinforced.

Lipofilling and lipostructure use a small centrifuge with fixed spinning speed (3500 Rpm. The high speed FAMI centrifuge (12000 Rpm-13680 G)destroys more large fat cells, leaving a higher percentage of stem cells in the pellet. The concentration of those stem cells increase with the spinning speed.

The stem cells cause the new tissue to form and to persist . The ruptured adipocytes die.

A.BALIN

The stem cells are responsible for the longevity of the FAMI graft. Remember that none of the mechanisms are proven, but these are our hypothesis.

A. BALIN

In the nineties Dr Roger Amar had the intuition that FAT was not a good material for grafting into the face. Why? because after 25 years of plastic surgery Dr Amar found that the fat cells called adipocytes cannot be transplanted safely. He believed on "Pre-adipocytes" or mesenchymal cells; they were resistant and more suitable for grafting in good vascularized bed as the muscles.

In 2001, a biologist P. Zuck demonstrated that multipotent cells called mesenchymal adult stem cells could be isolated from lipoaspirates. It was the explanation of the very long lasting good results of the FAMI Technique that DR Amar was looking for since 1997.

Now, the method was upgraded with a 13,500 g (force) purification and new cannulae to graft adult stem cells from fatty fibrous tissues to restore bone surfaces, muscles, fat pads and skin alterations.

All cosmetic rejuvenative techniques come down to two basic concepts: vectors and volumes. Vectors are the direction of pull or lifting; volumes are restoration of the normal facial fullness of youth. Facelifting focuses on lifting and relies on placing the volumes that are there in a better position. FAMI focuses on volume and relies on the filling to provide some lift. The two techniques can be complimentary as when facelifting has lifted and tightened facial contures but hasn't given a youthful look because the volumes are missing: FAMI can then help to give back youthful volumes.

The FAMI™ technique is an innovative approach that helps restore some of the underlying defects that are responsible for the appearance of ageing. It rejuvenates the face by implanting the patient's own adult mesenchymal stem cells, thus restructuring the facial skeletal and subcutaneous structure to a more youthful state.

Dr. Roger Amar's contributions have been to develop a technique of mesenchymal tissue integration that permits lasting improvement. It is likely that this approach will prove to be one of the best techniques to improve the appearance of ageing individuals.

As many authors have demonstrated, 2 days after the procedure, the tissue graft is anchored in the surrounding tissues by the new vascularizatiion, that comes from the host tissue."What you see in the Operating Room is what you get" WYSWYG RULE.

"In order to duplicate the likeness of youth, FAMI restore the fullness of bone,muscles and fat pads of the face".

Only the Dr Amar'scholars do the FAMI procedure.

Few doctors know how to perform FAMI because this technique has a very steep learning curve. Expertise in facial anatomy is mandatory. It is easier for a surgeon to cut for trimming the sagging facial tissues but to go safely deep into the face to inject a muscle origin, bone surfaces or the orbital rim needs a special knowledge. Only an anatomist surgeon can make the FAMI procedure safe for the patient. This knowledge cannot be found in the classical books. During the training courses Dr Roger Amar gives all his outstanding findings to the attendees and helps them with hands on to learn how to use the instrumentation. Whithout this anatomical teaching and training with proprietary instrumentation no one doctor could safely do the FAMI technique and could reach the quality of results obtained by Dr AMAR and few of his scholars or his son.

when fat injection is used the touch up rate is hight.

FAMI was developped to give more longevity and predictability.

From the beginning in 1997 FAMI is a technique with a near ZERO touch up rate. how? simple!

FAMI is not a fat injection but a connective tissue or mesenchymal cells GRAFTING!

Do you ask a surgeon how long a skin grafting last? and what is the touch up rate of a skin grafting? It is the same for Fat Autograft Muscle Injection or better named Fresh Autologous Mesenchymal Integration (FAMI. Tissues are put inside the muscle envelop and thanks to the rich vascularity the take is immediate and close to 100%.

Some rare patients with very skinny faces need a second session and a second reduced FAMI is done one year after the first one.

FAMI use the normal patient anatomy AS A TEMPLATE. and the photos of the patient younger as a model. To restore malar bones surface FAMI uses 13680 G to obtain very liquid mesenchymal tissues and inject them under the bone periosteum. The tightening of the cheek ligaments gives back the normal cheek prominence immediately.