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Effect of Fat Grafting on Postoperative Edema After Orthognathic Surgery

Cabrejo, Raysa, BA; Sawh-Martinez, Rajendra, MD, MHS; Steinbacher, Derek M., MD, DMD

Journal of Craniofacial Surgery: May 2019 - Volume 30 - Issue 3 - p 698–702
doi: 10.1097/SCS.0000000000005287
Original Articles
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Background: Autologous fat grafting concurrent with orthognathic surgery is a powerful adjunctive aesthetic tool, and has been shown to have anti-inflammatory properties in prior studies. The purpose of this study is to evaluate the effect of fat grafting on postoperative edema following orthognathic surgery, and also consider the impact of age and BMI.

Methods: A retrospective cohort study was performed. Three-dimensional photos (Canfield, Fairfield, NJ) from a series of postprocedure time-points were analyzed using Geomagic Studio 2013 (3D Systems, Morrisville, NC). An unstructured covariance linear mixed model was created to analyze the effect and extent of the effect of age, BMI, and fat using SPSS Statistics 24.0 (IBM, Armonk, NY).

Results: One hundred thirty postoperative three-dimensional pictures were analyzed, from 31 patients. The linear mixed model demonstrates that the fat injected (P<0.001), age (P=0.001), and BMI (P<0.001) are significant factors in the postoperative volume. Age and BMI increase postoperative edema by 3.63 cm3 per year and 14.60 cm3 per kg/m2, respectively. Fat injected reduces postoperative edema by 8.72 cm3 per 1 cc injected.

Conclusion: Increasing age and BMI lead to greater postoperative edema (3.88 cm3 per year and 14.60 cm3 per kg/m2, respectively). Fat grafting concurrent with orthognathic surgery reduces postoperative edema by 8.72 cm3 per 1 cc injected, and hastens return to steady state. This impact is more profound in patients with a greater age and BMI.

Section of Plastic Surgery, Department of Surgery, Yale Medical School, New Haven, CT.

Address correspondence and reprint requests to Derek M. Steinbacher, MD, DMD, Chief of Oral and Maxillofacial Surgery, Section of Plastic Surgery, Department of Surgery, Yale School of Medicine, P.O. Box 208041, New Haven, CT 06520-8041; E-mail: derek.steinbacher@yale.edu

Received 6 September, 2018

Accepted 1 December, 2018

Dr. Steinbacher receives research and grant funding from KI and Synthes. The other authors report no conflicts of interest.

© 2019 by Mutaz B. Habal, MD.