Objective. To present directions for solving the problem of choosing augmentation procedure and compare these techniques regarding effectiveness of correction of aging of the middle third of the face.

Material and methods. We selected (evidence level not less than 3) and presented several studies of biological properties of hyaluronic acid fillers, as well as compared with our own study of characteristics of adipose tissue. In these studies, hyaluronic acid fillers were used to correct the middle third of the face with injections into adipose tissue. In our own study, 40 patients underwent face fat grafting for augmentation of the middle third of the face. Preparing fat aspirate and injection technique were identical in all patients: decantation, centrifugation, retrograde injection of fat by tunneling in different planes. We analyzed action mechanism clinically and at the cellular level, effect of injected material on surrounding tissues in long-term period, positive effect on correction of face aging.

Results. We established the recommendations and clinical maps for step-by-step determination of criteria and indications for various methods of augmentation in each patient.

Conclusion. Possible methods for determining augmentation techniques in patients of different ages, types of facial aging, cosmetic history and degree of skin involution are presented. Maps of individual indications will help to identify criteria that have a decisive impact on the outcomes of procedures.

Keywords. lipofilling, autograft, hyaluronic acid, augmentation, types of facial aging, fillers