Variants of Fat Grafting: From Structural Fat Grafting to Microfat, Sharp-Needle Intradermal Fat (SNIF), Nanofat, Emulsion, SNIE, FAMI, and SEEFI

  • José M. Serra-Mestre
  • José M. Serra-Renom


The use of facial fat grafting has traditionally been limited to increasing the volume in the subcutaneous plane. Fat grafts have only rarely been applied in more superficial dermal planes or in deeper planes.

The recent development of new ways of processing fat has made it possible to obtain smaller diameter grafts which can be injected with either cannulas or sharp needles. This important step forward means that we can apply fat grafts to complement conventional surgical techniques, not just for use as fillers, but in fine remodeling as well as to improve fine lines and to enhance tissue quality.

This chapter describes the method for obtaining, processing, and injecting these new types of fat and discusses their main indications in facial rejuvenation.


Microfat SNIF Nanofat Emulsion SNIE FAMI SEFFI Lipofilling Fat grafting Structural fat grafting 



This work received no financial support. The authors have no financial interest to declare in relation to the contents.


  1. 1.
    Rohrich RJ, Pessa JE, Ristow B. The youthful cheek and the deep medial fat compartment. Plast Reconstr Surg. 2008;121(6):2107–12.CrossRefGoogle Scholar
  2. 2.
    Serra-Renom JM, Serra-Mestre JM. Periorbital rejuvenation to improve the negative vector with blepharoplasty and fat grafting in the malar area. Ophthal Plast Reconstr Surg. 2011;27(6):442–6.CrossRefGoogle Scholar
  3. 3.
    Rohrich RJ, Ghavami A, Constantine FC, et al. Lift-and-fill face lift: integrating the fat compartments. Plast Reconstr Surg. 2014;133(6):756e–67e.CrossRefGoogle Scholar
  4. 4.
    Wang W, Xie Y, Huang RL, et al. Facial contouring by targeted restoration of facial fat compartment volume: the midface. Plast Reconstr Surg. 2017;139(3):563–72.CrossRefGoogle Scholar
  5. 5.
    Park BS, Jang KA, Sung JH, et al. Adipose-derived stem cells and their secretory factors as a promising therapy for skin aging. Dermatol Surg. 2008;34(10):1323–6.PubMedGoogle Scholar
  6. 6.
    Tonnard P, Verpaele A, Peeters G, et al. Nanofat grafting: basic research and clinical applications. Plast Reconstr Surg. 2013;132(4):1017–26.CrossRefGoogle Scholar
  7. 7.
    Bernardini FP, Gennai A, Izzo L, et al. Superficial enhanced fluid fat injection (SEFFI) to correct volume defects and skin aging of the face and periocular region. Aesthet Surg J. 2015;35(5):504–15.CrossRefGoogle Scholar
  8. 8.
    Trepsat F. Midface reshaping with micro-fat grafting. Ann Chir Plast Esthet. 2009;54(5):435–43.CrossRefGoogle Scholar
  9. 9.
    Nguyen PS, Desouches C, Gay AM, et al. Development of micro-injection as an innovative autologous fat graft technique: the use of adipose tissue as dermal filler. J Plast Reconstr Aesthet Surg. 2012;65(12):1692–9.CrossRefGoogle Scholar
  10. 10.
    Lindenblatt N, van Hulle A, Verpaele AM, et al. The role of microfat grafting in facial contouring. Aesthet Surg J. 2015;35(7):763–71.CrossRefGoogle Scholar
  11. 11.
    Marten TJ, Elyassnia D. Fat grafting in facial rejuvenation. Clin Plast Surg. 2015;42(2):219–52.CrossRefGoogle Scholar
  12. 12.
    Vila Rovira R, Serra Renom JM. Microliposucción y Microinyección de grasa en la region facial. In: Vila Rovira R, Serra Renom JM, editors. Liposucción en cirugía Plástica y Estética. Barcelona: Salvat; 2007. p. 153–63.Google Scholar
  13. 13.
    Zeltzer AA, Tonnard PL, Verpaele AM. Sharp-needle intradermal fat grafting (SNIF). Aesthet Surg J. 2012;32(5):554–61.CrossRefGoogle Scholar
  14. 14.
    Gennai A, Zambelli A, Repaci E, et al. Skin rejuvenation and volume enhancement with the micro superficial enhanced fluid fat injection (M-SEFFI) for skin aging of the periocular and perioral regions. Aesthet Surg J. 2017;37(1):14–23.CrossRefGoogle Scholar
  15. 15.
    Coleman SR. Facial recontouring with lipostructure. Clin Plast Surg. 1997;24:347–67.PubMedGoogle Scholar
  16. 16.
    Serra-Renom JM, Serra-Mestre JM. Atlas of minimally invasive facelift: facial rejuvenation with volumetric lipofilling. Cham: Springer International Publishing AG; 2016.CrossRefGoogle Scholar
  17. 17.
    Osinga R, Menzi NR, Tchang LA, et al. Effects of intersyringe processing on adipose tissue and its cellular components: implications in autologous fat grafting. Plast Reconstr Surg. 2015;135(6):1618–28.CrossRefGoogle Scholar
  18. 18.
    Amar RE, Fox DM. The facial autologous muscular injection (FAMI) procedure: an anatomically targeted deep multiplane autologous fat-grafting technique using principles of facial fat injection. Aesthet Plast Surg. 2011;35(4):502–10.CrossRefGoogle Scholar
  19. 19.
    Butterwick KJ. Fat autograft muscle injection (FAMI): new technique for facial volume restoration. Dermatol Surg. 2005;31(11 Pt 2):1487–95.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • José M. Serra-Mestre
    • 1
  • José M. Serra-Renom
    • 1
  1. 1.Aesthetic, Plastic and Reconstructive Surgery DepartmentHospital Quirón Barcelona, Universitat Internacional de CatalunyaBarcelonaSpain

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