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Background <p>Facial sunken deformity caused by trauma, surgery, or skin disease often leads to aesthetic and functional impairment. Autologous fat grafting is widely used for volume restoration but is challenged by poor graft survival in scarred tissue. Combining fat grafting with botulinum toxin A (BoNTA) may improve graft retention via enhanced vascularization and reduced mechanical tension.</p> Methods <p>We retrospectively analyzed 43 patients with facial sunken deformity treated from January 2021 to January 2024. All patients were treated with V-shaped dissector cannula for subscar tissue release, fat harvesting from the abdomen, filtration of lipoaspirate, and fat grafting combined with local BoNTA injection. Outcomes were assessed using pre- and postoperative clinical photographs, 3D facial volumetric scanning, and patient satisfaction over a 6- to 12-month follow-up.</p> Results <p>Significant volume restoration was observed postoperatively with stable long-term outcomes. No serious complications occurred. Patients reported high satisfaction with aesthetic improvement and functional recovery.</p> Conclusion <p>The combined technique of V-shaped dissector cannula subcision, filtered fat grafting, and local BoNTA injection is a safe and effective method to correct facial sunken deformity, improving fat graft survival and contour restoration. This approach offers a promising option for managing challenging scar-related deformities.</p> Important points <p>This study proposes the following three technical innovations to enhance fat graft survival and improve the appearance of concave scars: (1) using a V-shaped dissector cannula&#xa0;to fully release underlying scar tissue; (2) processing fat using a filter to optimize graft quality; and (3) using botulinum toxin to promote fat vascularization.</p> Level of Evidence IV <p>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors <a href="http://www.springer.com/00266">www.springer.com/00266</a>.</p>

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Autologous Fat Graft Combined With Botulinum Toxin A Injection for Facial Sunken Deformity Treatment: A Retrospective Clinical Analysis

  • 期刊论文

  • 发表日期：

    2026年6月16日

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  • Na Wang,
  • Li-Ming Sun,
  • Si-Ming Wei,
  • Shuai Qiang,
  • Jia-Yang Wang,
  • Xian-Hui Zeng,
  • Na Ma,
  • Zhao-Xiang Zhang

摘要

Background

Facial sunken deformity caused by trauma, surgery, or skin disease often leads to aesthetic and functional impairment. Autologous fat grafting is widely used for volume restoration but is challenged by poor graft survival in scarred tissue. Combining fat grafting with botulinum toxin A (BoNTA) may improve graft retention via enhanced vascularization and reduced mechanical tension.

Methods

We retrospectively analyzed 43 patients with facial sunken deformity treated from January 2021 to January 2024. All patients were treated with V-shaped dissector cannula for subscar tissue release, fat harvesting from the abdomen, filtration of lipoaspirate, and fat grafting combined with local BoNTA injection. Outcomes were assessed using pre- and postoperative clinical photographs, 3D facial volumetric scanning, and patient satisfaction over a 6- to 12-month follow-up.

Results

Significant volume restoration was observed postoperatively with stable long-term outcomes. No serious complications occurred. Patients reported high satisfaction with aesthetic improvement and functional recovery.

Conclusion

The combined technique of V-shaped dissector cannula subcision, filtered fat grafting, and local BoNTA injection is a safe and effective method to correct facial sunken deformity, improving fat graft survival and contour restoration. This approach offers a promising option for managing challenging scar-related deformities.

Important points

This study proposes the following three technical innovations to enhance fat graft survival and improve the appearance of concave scars: (1) using a V-shaped dissector cannula to fully release underlying scar tissue; (2) processing fat using a filter to optimize graft quality; and (3) using botulinum toxin to promote fat vascularization.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.