The FAMI technique with mesenchymal stem cells, pan facial rejuvenation without a scalpel

Abstract

The classical fat transfer techniques have lost their popularity because of painful sessions and enormous bruising for short-lasting effects with necessity of additional sessions to correct the lumpy results. Therefore, now, a majority of professional plastic surgeons are using fat injections as an adjuvant technique during facelift (lipofilling, nanofat). Facial Autologous Muscle Injection, abbreviated as FAMI®, was created in 1998 in Marseille (France) by Roger Amar and published in 1999 in the French journal of plastic surgery. The FAMI technique was set with the ambition to create a non-incisional pan-facial rejuvenation procedure based on new 3D dissection anatomy database. FAMI carried three innovations: first, the use of a tuneable centrifuge, from 1500Gf to 13,680Gf, to concentrate the mesenchymal tissues to inject; second, the injection of 30 muscles of facial expression divided in three planes, as a recipient targets; and third, a specific proprietary instrumentation adapted to the skull curvatures to make the deposit of the graft harmless and bloodless. The technique put more science on fat grafting than current methods, by destroying the large fat lobules and concentrating a very fluid excerpt from fat (SVF) which is the support of adipose adult stem cells (ADSCs) and by injecting in deep facial structures as mimic muscles, deep fat pads, and skull periosteum, giving predictability and longevity to the graft. What you see in the OR is what you get. Between 1998 and 2020, 1226 patients were operated on successfully, mainly for rejuvenation in upper face, mid-face, or lower face. Single or rarely two sessions of the FAMI® technique, were necessary for more rejuvenated facial curves and contours. FAMI is a "one session systematized pan facial restoration". The revascularization of the transplant is good, and the graft lasts virtually indefinitely without any touch-up. FAMI is a very simple technique of injection for the patient but very complex for the surgeon who needs to develop a true expertise in facial 3D anatomy by dissecting numberless cadavers.