Facial Plast Surg
DOI: 10.1055/a-2188-8608
Original Article

PHAT Lips and PHAT Face: Platelet Hybridized Adipose Therapy for Superficial Musculoaponeurotic System and Dermal Rejuvenation

Benjamin Talei
1   Beverly Hills Center for Facial Plastic Surgery, Beverly Hills, California
Hedyeh Ziai
1   Beverly Hills Center for Facial Plastic Surgery, Beverly Hills, California
› Author Affiliations


Platelet-rich plasma has been increasingly used for facial rejuvenation in conjunction with other modalities such as microneedling or on its own. Nanofat grafting to the face has also been utilized for skin quality improvements. Our group previously described the novel combined Platelet Hybridized Adipose Transplant (PHAT) technique for hair restoration. In this series, we describe our experience with the PHAT technique for lip and facial rejuvenation to improve the quality of facial skin and superficial musculoaponeurotic system, and enhancing surgical results.

Publication History

Accepted Manuscript online:
10 October 2023

Article published online:
20 November 2023

© 2023. Thieme. All rights reserved.

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  • References

  • 1 Talei B, Shauly O, Gould D. Platelet rich plasma hybridized adipose transplant (PHAT) for the treatment of hair loss: a case series. Aesthet Plast Surg 2021; 45 (06) 2760-2767
  • 2 Okuda I, Yoshioka N, Shirakabe Y, Akita K. Basic analysis of facial ageing: the relationship between the superficial musculoaponeurotic system and age. Exp Dermatol 2019; 28 (Suppl. 01) 38-42
  • 3 Talei B, Pearlman SJ. CUPID Lip Lift: advanced lip design using the deep plane upper lip lift and simplified corner lift. Aesthet Surg J 2022; 42 (12) 1357-1373
  • 4 Tobin DJ. Introduction to skin aging. J Tissue Viability 2017; 26 (01) 37-46
  • 5 Mitz V, Peyronie M. The superficial musculo-aponeurotic system (SMAS) in the parotid and cheek area. Plast Reconstr Surg 1976; 58 (01) 80-88
  • 6 Jacono A, Bryant LM. Extended deep plane facelift: incorporating facial retaining ligament release and composite flap shifts to maximize midface, jawline and neck rejuvenation. Clin Plast Surg 2018; 45 (04) 527-554
  • 7 Minelli L, van der Lei B, Mendelson BC. The superficial musculo-aponeurotic system (SMAS): does it really exist as an anatomic entity?. Plast Reconstr Surg 2023
  • 8 Khavkin J, Ellis DA. Aging skin: histology, physiology, and pathology. Facial Plast Surg Clin North Am 2011; 19 (02) 229-234
  • 9 Emer J. Platelet-rich plasma (PRP): current applications in dermatology. Skin Therapy Lett 2019; 24 (05) 1-6
  • 10 Peng GL. Platelet-rich plasma for skin rejuvenation: facts, fiction, and pearls for practice. Facial Plast Surg Clin North Am 2019; 27 (03) 405-411
  • 11 Jeyaraman M, Muthu S, Sharma S, Ganta C, Ranjan R, Jha SK. Nanofat: a therapeutic paradigm in regenerative medicine. World J Stem Cells 2021; 13 (11) 1733-1746
  • 12 Cervelli V, Gentile P, Scioli MG. et al. Application of platelet-rich plasma in plastic surgery: clinical and in vitro evaluation. Tissue Eng Part C Methods 2009; 15 (04) 625-634
  • 13 D'Esposito V, Passaretti F, Perruolo G. et al. Platelet-rich plasma increases growth and motility of adipose tissue-derived mesenchymal stem cells and controls adipocyte secretory function. J Cell Biochem 2015; 116 (10) 2408-2418
  • 14 Tonnard P, Verpaele A, Carvas M. Fat grafting for facial rejuvenation with Nanofat grafts. Clin Plast Surg 2020; 47 (01) 53-62
  • 15 Ding P, Lu E, Li G, Sun Y, Yang W, Zhao Z. Research progress on preparation, mechanism, and clinical application of Nanofat. J Burn Care Res 2022; 43 (05) 1140-1144
  • 16 Stachura A, Paskal W, Pawlik W, Mazurek MJ, Jaworowski J. The use of adipose-derived stem cells (ADSCs) and stromal vascular fraction (SVF) in skin scar treatment-a systematic review of clinical studies. J Clin Med 2021; 10 (16) 3637
  • 17 Stuzin JM. Discussion: Nanofat grafting: basic research and clinical applications. Plast Reconstr Surg 2013; 132 (04) 1027-1028
  • 18 La Padula S, Ponzo M, Lombardi M. et al. Nanofat in plastic reconstructive, regenerative, and aesthetic surgery: a review of advancements in face-focused applications. J Clin Med 2023; 12 (13) 4351
  • 19 Ramirez H, Patel SB, Pastar I. The role of TGFβ signaling in wound epithelialization. Adv Wound Care (New Rochelle) 2014; 3 (07) 482-491
  • 20 Quaglino Jr D, Nanney LB, Ditesheim JA, Davidson JM. Transforming growth factor-beta stimulates wound healing and modulates extracellular matrix gene expression in pig skin: incisional wound model. J Invest Dermatol 1991; 97 (01) 34-42
  • 21 Barrientos S, Stojadinovic O, Golinko MS, Brem H, Tomic-Canic M. Growth factors and cytokines in wound healing. Wound Repair Regen 2008; 16 (05) 585-601
  • 22 Miller-Kobisher B, Suárez-Vega DV, Velazco de Maldonado GJ. Epidermal growth factor in aesthetics and regenerative medicine: systematic review. J Cutan Aesthet Surg 2021; 14 (02) 137-146
  • 23 Noordam R, Gunn DA, Tomlin CC. et al; Leiden Longevity Study group. Serum insulin-like growth factor 1 and facial ageing: high levels associate with reduced skin wrinkling in a cross-sectional study. Br J Dermatol 2013; 168 (03) 533-538
  • 24 Badran KW, Sand JP. Platelet-rich plasma for hair loss: review of methods and results. Facial Plast Surg Clin North Am 2018; 26 (04) 469-485
  • 25 Giusti I, Rughetti A, D'Ascenzo S. et al. Identification of an optimal concentration of platelet gel for promoting angiogenesis in human endothelial cells. Transfusion 2009; 49 (04) 771-778
  • 26 Gentile P, Garcovich S. Systematic review-The potential implications of different platelet-rich plasma (PRP) concentrations in regenerative medicine for tissue repair. Int J Mol Sci 2020; 21 (16) 5702
  • 27 Tonnard P, Verpaele A, Peeters G, Hamdi M, Cornelissen M, Declercq H. Nanofat grafting: basic research and clinical applications. Plast Reconstr Surg 2013; 132 (04) 1017-1026
  • 28 Piccolo NS, Piccolo MS, de Paula Piccolo N. et al. Fat grafting for treatment of facial burns and burn scars. Clin Plast Surg 2020; 47 (01) 119-130
  • 29 Gargano F, Schmidt S, Evangelista P. et al. Burn scar regeneration with the “SUFA” (Subcision and Fat Grafting) technique. A prospective clinical study. [published correction appears in JPRAS Open. 2021 Sep 24;30:174–175] JPRAS Open 2018; 17: 5-8
  • 30 Riyat H, Touil LL, Briggs M, Shokrollahi K. Autologous fat grafting for scars, healing and pain: a review. Scars Burn Heal 2017; 3: 2059513117728200
  • 31 Fang Z, Yang X, Wu G. et al. The use of autologous platelet-rich plasma gel increases wound healing and reduces scar development in split-thickness skin graft donor sites. J Plast Surg Hand Surg 2019; 53 (06) 356-360
  • 32 Gaur M, Dobke M, Lunyak VV. Mesenchymal stem cells from adipose tissue in clinical applications for dermatological indications and skin aging. Int J Mol Sci 2017; 18 (01) 208
  • 33 Pagani A, Aitzetmüller MM, Brett EA. et al. Skin rejuvenation through HIF-1α modulation. Plast Reconstr Surg 2018; 141 (04) 600e-607e
  • 34 Gould DJ. Tissue engineering for plastic surgeons: a primer commentary. Aesthetic Plast Surg 2014; 38 (01) 222-223
  • 35 Saik JE, Gould DJ, Watkins EM, Dickinson ME, West JL. Covalently immobilized platelet-derived growth factor-BB promotes angiogenesis in biomimetic poly(ethylene glycol) hydrogels. Acta Biomater 2011; 7 (01) 133-143
  • 36 Ali S, Saik JE, Gould DJ, Dickinson ME, West JL. Immobilization of cell-adhesive laminin peptides in degradable PEGDA hydrogels influences endothelial cell tubulogenesis. Biores Open Access 2013; 2 (04) 241-249