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Isolated Fat Grafting for Reconstruction of Lower Face Volumetric Asymmetry in Skeletally Immature Patients

A Clinical Outcome Study

Denadai, Rafael MD; Raposo-Amaral, Cesar Augusto MD; Buzzo, Celso Luiz MD, Msc; Raposo-Amaral, Cassio Eduardo MD, PhD

doi: 10.1097/SAP.0000000000001934
Head and Neck Surgery

Background The purpose of this study was to assess the objective and subjective outcomes of lower face volumetric (contour) asymmetry correction with isolated fat grafting in skeletally immature patients.

Methods A prospective analysis was conducted of skeletally immature patients (n = 73) with craniofacial microsomia and Parry-Romberg syndrome who underwent isolated fat grafting (with no previous or concomitant bone surgery) using anatomical surgical principles (facial subunits and fat compartments) for the reconstruction of lower face volumetric asymmetry. Objective ultrasound and photogrammetric lower face symmetry analyses were blindly performed preoperatively and at 3 and 12 months postoperatively. A panel assessment of blinded surgical professionals and laypersons was also obtained to grade the subjective lower face symmetry.

Results There were significant (all P < 0.05) postoperative objective and subjective lower face symmetry enhancements (preoperative < postoperative) after isolated fat grafting, with no differences (all P > 0.05) between 3 versus 12 months' postoperative comparisons.

Conclusions Growing patients with unilateral lower face volumetric asymmetries presented with improvement of objective and subjective symmetry after a single isolated fat grafting procedure.

From the Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Campinas, São Paulo, Brazil.

Received January 1, 2019, and accepted for publication, after revision February 18, 2019.

Conflicts of interest and sources of funding: none declared.

Reprints: Rafael Denadai, MD, Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Av. Adolpho Lutz, 100, Caixa Postal 6028, Campinas, São Paulo CEP 13084-880, Brazil. E-mail:

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Online date: June 20, 2019

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