Ultrasound-Assessed Facial Macrofat Retention After Facelift

Research question Among adults undergoing facelift with standardized facial macrofat grafting, what proportion of the ultrasound-derived grafted tissue volume is retained at 12 months, and what structural changes occur in the facial subcutaneous tissue? Primary hypothesis Ultrasound-derived grafted tissue volume will show measurable persistence at 12 months, with stable or improved subcutaneous tissue thickness and organization and an acceptable rate of fat-grafting-related complications.

Primary objective To estimate the percentage retention of ultrasound-derived facial graft volume at 12 months relative to the postoperative month-1 reference assessment.

Secondary objectives

• To quantify zone-specific changes in facial subcutaneous thickness, echogenicity, homogeneity, and vascularity.
• To evaluate the association between injected macrofat volume and retained ultrasound-derived volume.
• To document fat-grafting-related adverse events, including clinically significant nodules, cysts, infection, contour irregularity, and need for revision.
• To measure patient-reported satisfaction with facial appearance using selected FACE-Q scales, subject to licensing and final scale selection.

Inclusion criteria

• Age 18 to 65 years.
• Scheduled for elective facelift surgery with facial autologous macrofat grafting specified before enrollment.
• Ability to undergo standardized facial ultrasound at baseline, postoperative month 1, and postoperative month 12.
• Capacity to provide written informed consent and comply with follow-up visits.

Exclusion criteria

• Prior facial fat grafting within 24 months before enrollment.
• Active facial infection, uncontrolled inflammatory skin disease, or open facial wound.
• Known lipodystrophy or systemic disease expected to substantially alter facial fat distribution during follow-up.
• Planned major weight-loss intervention or anticipated body-weight change greater than 10% during follow-up.
• Pregnancy or breastfeeding at enrollment.
• Inability to obtain technically adequate baseline ultrasound measurements in the predefined facial zones.