Introduction: Soft tissue volume augmentation procedures such as lipofilling and soft tissue fillers for reversing facial aging process have been well accepted in recent years, fat tissue derivatives such as nanofat and SVF-Gel are also be proved to play important role in improving skin texture and quality. Volume loss is largely observed in the upper two thirds of the face, whereas fat is usually accumulated in the lower one third of the face and the neck regions. Taken together, volume changes in the face and neck, along with the tethering effects of retaining ligaments as well as gravity all account for the aging appearance in the face, submandibular ,submental and neck regions such as deepening of nasolabial folds, jowls formation , loss of defined mandibular border and loss of normal cervicomental angle.
Method: According to the regional changes observed with the aging face, the author applied the corresponding correcting strategies with volume augmentation using microfat grafting in the upper two thirds of the face and volume reduction and skin tightening in the lower face and neck by using Smartlipo MPX laser assisted lipolysis or Facetite radiofrequency assisted lipolysis techniques, moreover nanofat and/or SVF-Gel are applied in selected patients for improving skin textures through their regenerative properties.
Results: By microfat augmentation as well as nanofat and SVF-Gel injection in the upper two thirds of the face and/or fat reduction and skin tightening in the lower third of the face and the neck, satisfactory results have been obtained both in using those techniques separately or combined in one session, there is no major complications among cases treated with the protocol. Edema resolution varies individually and is usually treated sites dependent. It is necessary and helpful to wear an elastic mask after the lipolysis procedures. The pros and cons of staged operations for fat augmentation and fat reduction procedure or a combined procedure including both in one session are also discussed.
Conclusion: Microfat grafting and nanofat and SVF-Gel injection can effectively restore the youthful fullness of facial appearance by correcting volume loss in the upper two thirds of aging face, traditional liposuction with laser or radiofrequency assisted lipolysis and skin tightening is mini-invasive and is a good alternative to lifting procedures in correcting jowls and submental fat accumulation and descent in lower third of the face and neck regions. Better results and high patient satisfaction are anticipated with combined usage of these techniques in one session.

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