Commentary on: Evaluation of Facial Volume Changes after Rejuvenation Surgery Using a 3-Dimensional Camera.

Facial aging has been the object of various facial rejuvenation approaches throughout the years. To obtain a natural and pleasing rejuvenation effect, it is essential to understand and diagnose the underlying anatomic and age-related changes in order to propose the most appropriate treatment. In this sense, three main categories of age-related changes must be analyzed: (1) skin surface breakdown and changes; (2) skin and soft tissue redundancy and ptosis; and (3) deflation of facial volumes by atrophy and hollowing of underlying soft tissue compartments. Skin care and skin resurfacing procedures were developed to treat the first group of problems, while traditional facelifts and necklifts address the skin redundancy and soft tissue ptosis. The growing appreciation of the loss of facial fat and soft tissue volumes in the face over the last 20 years have led to the introduction and widespread use of fillers and filling techniques, including fat grafting.1,2 The latter has been increasingly used in the last 10 years in association with facelift procedures, based on detailed anatomic studies and clinical series.3,4 Fat grafting is the best surgical option for volume restoration because it is natural, biocompatible and allows for skin quality improvement.5 One of the major drawbacks of fat grafting, however, remains the uncertainty of the results due to unpredictable resorption rates. This is especially true for the facial region where …