Left to right: Donald M. Fox, MD, FACS, Roger Amar, MD.

www.rogeramar.com

What is FAMI?

FAMI has been developed over the last ten years by French plastic surgeon, Roger Amar, MD and represents a major advance in aesthetic and reconsructive facial fat grafting.When it was originally conceived, FAMI stood for Facial Autograft Muscular Injection.  As it became clear that adult multipotent mesenchymal stems cells within the fat were contributing the most important aspects of the results, FAMI was modified to Facial Autograft Mesenchymal Injection.  Dr. Amar's insight was to place the fat autograft into the muscles of the face using specialized cannulas shaped to the contours of the face,  as opposed to just under the skin as common fat grafting does.  By placing the fat and mesenchymal stem cells into the rich vascular bed of the muscles, their chances of survival are enhanced.  By using a person's own facial muscles as the model for graft placement, a person's natural  appearance is preserved - you don't end up looking like you never did,  as sometimes happens with "cut and pull" face-lifting techniques.

What is autograft?

An autograft is tissue taken from one part of a person's body and placed in another part of the same person.  Skin grafting, for example, is autografting.  It is tissue from yourself to yourself for yourself.

How does FAMI compare to facelifting?

All cosmetic rejuvenative techniques come down to two basic concepts: vectors and volumes.  Vectors are the direction of pull or lifting; volumes are restoration of the normal facial fullness of youth.  Facelifting focuses on lifting and relies on placing the volumes that are there in a better position.  FAMI focuses on volume and relies on the filling to provide some lift.  The two techniques can be complimentary as when facelifting has lifted and tightened facial contures but hasn't given a youthful look because the volumes are missing: FAMI can then help to give back youthful volumes.

Click on the right (blue) half of the image to view a detailed image of the facial muscles

What is the scientific evidence behind adult mesenchymal stem cells?

There is a sustantial and growing body of basic, laboratory and animal research about adult mesenchymal stem cells and their properties. Mesenchymal is the scientific term for those cells that create the structural parts of our bodies: bone, muscle, tendons, ligaments, fascia, and fat.  For those who have the patience and curiosity, some literature citations are given below.

Basically, there are stem cells throughout our bodies waiting to be called into action by the effects of aging or injury.  This population of mature, or adult, stem cells - as opposed to embryonic stem cells - is high when we are young and steadily declines as we age.  Indeed,  one theory of aging (apart from disease) has it that we die when we run out of stem cells sufficient to replace the natural turnover of cells in our body. The most abundant and easily obtainable source of these stem cells is our own body's fat.  When these cells are collected by a process called lipoharvesting (mini-liposuction), they are placed into many layers of the face along with the fat during the FAMI procedure. Exactly what happens to these adult mesenchymal stem cells is not yet known in humans, but we feel they are part of the rejuvenative process. FAMI is a trademark of the AMAR Charitable Foundation.

Zuk, PA; Zhu, M; Mizuno, H; Huang, J; Futrell, JW; Katz, AJ; Benhaim, P; Lorenz, HP; Hedrick, MH  Multilineage cells from adipose tissue: Implications for cell-based therapies.  Tissue Eng. 7:211-228; 2001

Bacou, F; Andalousi, RB; Daussin, PA; Micallef, JP; Levin, JM; Chammas, M; Casteilla, L; Reyne, Y; Nougues, J.  Transplantation of Adipose Tissue-Derived Stromal Cells Increases Mass and Functional Capacity of Damaged Skeletal Muscle.  Cell Transplantation, Vol 13, pp103-111, 2004.