Facial & Under-Eye Fat Grafting Instruments

Facial fat grafting is a small-volume, high-precision job. The face, and the under-eye in particular, needs small parcels of fat placed in many fine passes, deep enough that the thin skin does not show them. That decides every instrument in the chain: how you infiltrate, which harvester you use, how you process the fat and which cannula places it. This page sets out the CLINIMED instruments for each step, what the published literature says about the under-eye, and the ready-made facial sets.

Which graft where

Grafts are now usually grouped by parcel size into macrofat, microfat and nanofat.¹ Macrofat restores volume in the temples, cheeks and jawline. Microfat, harvested through holes of about 1 mm, is used where the skin is thin or the contour is fine: the tear trough, orbitomalar groove, lips and nasolabial folds.^2–4 Nanofat is emulsified and filtered microfat; it contains no viable adipocytes and is used for skin quality, fine lines and dark lower eyelids, not for volume.⁵

The under-eye and tear trough

The lower eyelid is the hardest place to graft well. The skin is thin, so a parcel placed too superficially shows as a lump. One series attributed its few contour irregularities to superficial injection, noting that the deeper the fat is placed, the less chance of skin irregularities, "especially critical in the periorbita".⁷ Contour irregularity is named as the main challenge of periocular grafting,⁸ and a meta-analysis of 4,046 periorbital cases found an overall complication rate of 7.9%, most often oedema, chemosis and contour irregularity.⁹ In one series, visible lobules under the lower lid resolved once the injection cannulas and technique were changed.¹⁰

What that means for instruments:

• Fine placement cannulas. Periorbital fat is most commonly injected from a 1 mL syringe through 0.7–1.2 mm microcannulas;⁷ Lam injects the face from 1 mL syringes with 1.2 mm and 0.9 mm blunt cannulas.¹² CLINIMED makes the S. Coleman Fig. 1 and the Little Injector in this range (Ø0.9, 1.0 and 1.2 mm).
• Small parcels from the start. Harvest with a fine multi-hole harvester rather than relying on processing to make large parcels small.
• Nanofat for the skin, not the hollow. Nanofat has been used for dark lower eyelids,⁵ but it does not add volume; the hollow itself is filled with microfat.
• Fractionated fat, a middle option. Rohrich and colleagues emulsify centrifuged fat between two 10 mL syringes through a 2 mm filter 60–80 times and use this fractionated fat for the periorbital region, injected through a blunt cannula from three access points;¹³ they find the lid–cheek junction and orbital hollowing best addressed with fractionated fat.¹⁴

Step 1 · Harvest

For the face, the harvester decides parcel size. Our CLINIMED harvesters are named for their hole size: NANO has 240 radial holes of 500 µm, MICRO has 50 radial holes of 1000 µm, both with 360° extraction. For the face, Rohrich and colleagues recommend a small harvesting cannula with 1 × 1 mm holes so that appropriately sized lobules are harvested.¹⁴ Periocular fat has been harvested through a 0.5 mm multi-hole cannula,⁸ and in a study of superficial fat harvested with a 2 mm microcannula with 1 mm ports, the yield of adipose-derived stem cells was significantly higher than with a standard 3 mm cannula.¹¹

Step 2 · Process

Small-volume grafting is a syringe workflow. Harvest into 10 mL syringes, cap them and let them decant tip-down in a stand; transfer the purified fat into small syringes for placement. Lam, for example, moves processed fat into 1 mL syringes through a female-to-female luer transfer hub;¹² CLINIMED's anaerobic transfer hubs do the same job, closed to air. For nanofat, emulsify between two syringes and filter. The PURE Nano Fat (PNF™) hub with replaceable mesh screens handles both steps.

Step 3 · Place

The S. Coleman figure numbers describe the shape of the tip, not its size: each figure is made in several diameters. They follow the infiltration cannula types Dr. Coleman describes: Type I is completely capped, with a lip extending 180° over the opening, and is his workhorse for most facial fat grafting; Type II is partially capped (a lip of about 130–150°), useful in most situations but a little more traumatic; Type III has a flat, uncapped end for fibrotic tissue, old scars or subdermal placement; sharper V and W dissectors release adhesions.¹⁵ For the full method, read the Coleman technique and its instruments.

Ready-made facial sets

Every set lists each component by SKU on its product page, so you can see exactly what is in the tray.

Built the CLINIMED way

• 304 stainless steel, electrochemically polished inside and out, lumen included.
• Reusable and autoclavable, with lumen brushes and flexible picks available for cleaning.
• Made to order: every cannula is built for your order, so you can specify the length you need.
• Diameters in millimetres, colour-coded aluminium hubs, Secure Luer™ as standard on fine cannulas; other hubs on request.
• FDA registered · ISO 13485, serving surgeons since 1978.

Further reading

• Nanofat vs microfat: the instruments behind each technique
• The Coleman technique: instruments for structural fat grafting
• How to choose a liposuction cannula: a clinical selection guide
• Liposuction cannula sizes and colour codes
• Autologous fat grafting (AFG) collection · Re-injection cannulas · All sets

Frequently asked questions

What cannula size is used for under-eye fat grafting?

Periorbital fat is most commonly injected from a 1 mL syringe through 0.7–1.2 mm microcannulas, placed deep rather than just under the skin. CLINIMED makes the S. Coleman Fig. 1 and the Little Injector in Ø0.9, 1.0 and 1.2 mm.

What is the difference between Coleman Fig. 1, Fig. 2 and Fig. 3?

The figure number describes the tip shape, not the size, and follows the cannula types Dr. Coleman describes. Type I is completely capped and is his workhorse for most facial fat grafting; Type II is partially capped and a little more traumatic; Type III has a flat, uncapped end for fibrotic tissue, scars or subdermal placement. Each is made in several diameters.

Should I use nanofat or microfat under the eyes?

They do different jobs. Microfat restores volume in the tear trough and lid–cheek junction. Nanofat contains no viable adipocytes and does not add volume; it has been used to improve the skin of dark lower eyelids. Some surgeons combine the two.

Which harvester gives the smallest parcels?

The CLINIMED NANO harvester, with 240 radial holes of 500 µm. The MICRO harvester has 50 holes of 1000 µm, in the hole range published for microfat.

Are CLINIMED facial cannulas reusable and can I choose the length?

Yes. They are 304 stainless steel, electrochemically polished inside and out, reusable and autoclavable, and every cannula is made to order, so you can specify the length.

References

1. Strong AL, Rohrich RJ, Tonnard PL, et al. Technical precision with autologous fat grafting for facial rejuvenation: a review of the evolving science. Plast Reconstr Surg 2024;153(2):360–77. doi:10.1097/PRS.0000000000010643
2. Nguyen PSA, Desouches C, Gay AM, Hautier A, Magalon G. Development of micro-injection as an innovative autologous fat graft technique: the use of adipose tissue as dermal filler. J Plast Reconstr Aesthet Surg 2012;65(12):1692–9. doi:10.1016/j.bjps.2012.06.014
3. Tonnard PL, Verpaele AM, Zeltzer AA. Augmentation blepharoplasty: a review of 500 consecutive patients. Aesthet Surg J 2013;33(3):341–52. doi:10.1177/1090820X13478966
4. Tonnard PL, Verpaele AM, Ramaut LE, Blondeel PN. Aging of the upper lip: Part II. Evidence-based rejuvenation of the upper lip—a review of 500 consecutive cases. Plast Reconstr Surg 2019;143(5):1333–42. doi:10.1097/PRS.0000000000005589
5. Tonnard P, Verpaele A, Peeters G, et al. Nanofat grafting: basic research and clinical applications. Plast Reconstr Surg 2013;132(4):1017–26. doi:10.1097/PRS.0b013e31829fe1b0
6. Zeltzer AA, Tonnard PL, Verpaele AM. Sharp-needle intradermal fat grafting (SNIF). Aesthet Surg J 2012;32(5):554–61. doi:10.1177/1090820X12445082
7. Larsson JC, et al. Integrating fat graft with blepharoplasty to rejuvenate the Asian periorbita. Plast Reconstr Surg Glob Open 2019;7:e2365. doi:10.1097/GOX.0000000000002365
8. Pelle-Ceravolo M, Angelini M. Properly diluted fat (PDF): an easy and safe approach to periocular fat grafting. Aesthet Surg J 2020;40(1):19–33. doi:10.1093/asj/sjz039
9. Yang F, et al. Efficacy, safety and complications of autologous fat grafting to the eyelids and periorbital area: a systematic review and meta-analysis. PLoS One 2021;16(4):e0248505. doi:10.1371/journal.pone.0248505
10. Lindenblatt N, van Hulle A, Verpaele AM, Tonnard PL. The role of microfat grafting in facial contouring. Aesthet Surg J 2015;35(7):763–71. doi:10.1093/asj/sjv083
11. Trivisonno A, Di Rocco G, Cannistra C, et al. Aesthet Surg J 2014;34(4):601–13. doi:10.1177/1090820X14528000
12. Lam SM. Fat grafting for facial contouring. Facial Plast Surg 2019;35(3):278–85. doi:10.1055/s-0039-1688796
13. Rohrich RJ, Dayan E, Savetsky IL. Fat grafting to the face as an isolated procedure. Book chapter 13. New York: Thieme.
14. Schultz KP, Raghuram A, Davis MJ, Abu-Ghname A, Chamata E, Rohrich RJ. Fat grafting for facial rejuvenation. Semin Plast Surg 2020;34(1):30–7. doi:10.1055/s-0039-3402767 (free full text)
15. Egro FM, Roy E, Rubin JP, Coleman SR. Evolution of the Coleman technique. Plast Reconstr Surg 2022;150(2):329e–336e, Supplemental Digital Content 1. doi:10.1097/PRS.0000000000009355

Educational information for qualified surgeons. It does not replace clinical judgment or the instructions for use. COLEMAN™ is a trademark of its owner. MicroAire®, PAL®, Nouvag®, Liposurg® and VASER® are trademarks of their respective owners; CLINIMED is not affiliated with the owners of these marks.