Although there are numerous clinical reports relating to the injection of a
dipose tissue fragments, only few histological assessments of the histology
of these grafts in late follow-up have been made. The authors report a cas
e of adipose tissue harvested with a sharp cannula using low-pressure sucti
on and injection in the lower eyelid areas with subsequent sagging of the g
raft, although maintenance of volume, after 2 years. The operative correcti
ve procedure consisted of a lower blepharoplasty and removal of the sheathe
d graft. Histology showed extended oil cysts and a surrounding capsulelike
structure. The volume of the graft consisted mainly of oil cysts, and not h
ealthy adipose tissue. The conclusion is that the harvesting procedure dama
ges fragile adipocytes. The outcome of adipose tissue injection thus remain
s unpredictable. The only reliable guarantee for a good long-term outcome a
fter lipofilling is a specimen biopsy showing healthy adipose tissue.