Ultrasound-Assessed Facial Macrofat Retention After Facelift

Ultrasound-Assessed Facial Macrofat Retention After Facelift

Facelift surgery repositions facial soft tissues but does not by itself restore all age-related volume loss. Autologous macrofat can be placed during the same operation to restore volume, yet the amount of grafted tissue that remains and the way the facial subcutaneous layer remodels are not routinely quantified. This study will prospectively standardize injected-volume recording and ultrasound mapping of predefined facial zones. A one-month scan, obtained after the early postoperative period, will serve as the imaging reference for the grafted tissue compartment, and a one-year scan will quantify persistent volume and tissue remodeling.

Research question Among adults undergoing facelift with standardized facial macrofat grafting, what proportion of the ultrasound-derived grafted tissue volume is retained at 12 months, and what structural changes occur in the facial subcutaneous tissue? Primary hypothesis Ultrasound-derived grafted tissue volume will show measurable persistence at 12 months, with stable or improved subcutaneous tissue thickness and organization and an acceptable rate of fat-grafting-related complications.

Primary objective To estimate the percentage retention of ultrasound-derived facial graft volume at 12 months relative to the postoperative month-1 reference assessment.

Secondary objectives

• To quantify zone-specific changes in facial subcutaneous thickness, echogenicity, homogeneity, and vascularity.
• To evaluate the association between injected macrofat volume and retained ultrasound-derived volume.
• To document fat-grafting-related adverse events, including clinically significant nodules, cysts, infection, contour irregularity, and need for revision.
• To measure patient-reported satisfaction with facial appearance using selected FACE-Q scales, subject to licensing and final scale selection.

Inclusion Criteria:

• Age 18 to 65 years.
• Scheduled for elective facelift surgery with facial autologous macrofat grafting specified before enrollment.
• Ability to undergo standardized facial ultrasound at baseline, postoperative month 1, and postoperative month 12.
• Capacity to provide written informed consent and comply with follow-up visits.

Exclusion Criteria:

• Prior facial fat grafting within 24 months before enrollment.
• Active facial infection, uncontrolled inflammatory skin disease, or open facial wound.
• Known lipodystrophy or systemic disease expected to substantially alter facial fat distribution during follow-up.
• Planned major weight-loss intervention or anticipated body-weight change greater than 10% during follow-up.
• Pregnancy or breastfeeding at enrollment.
• Inability to obtain technically adequate baseline ultrasound measurements in the predefined facial zones.