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Influence of the Recipient Site on the Outcomes of Fat Grafting in Facial Reconstructive Surgery

Mojallal, Ali M.D.; Shipkov, Christo M.D.; Braye, Fabienne M.D.; Breton, Pierre M.D.; Foyatier, Jean-Louis M.D.

Plastic and Reconstructive Surgery: August 2009 - Volume 124 - Issue 2 - p 471-483
doi: 10.1097/PRS.0b013e3181af023a
Reconstructive: Head and Neck: Original Articles

Background: The purpose of this study was to analyze the role of fat grafting for restoration of facial contour deformities (volumes) in traumatic and malformation cases. Outcomes were evaluated for each facial aesthetic subunit to demonstrate the role of the recipient site. An algorithm for the treatment of facial malformations and traumatic sequelae by subunits, in relation to the results obtained in this study, is proposed.

Methods: This retrospective study involved 100 patients treated by structural fat grafting of the facial region. Results were evaluated by a subjective self-evaluation survey (i.e., a questionnaire answered by patients) and an objective assessment by a five-member jury. Each subunit of the face was studied separately. Results were presented separately and compared.

Results: The average follow-up period was 23 months. The overall satisfaction rate of patients was 74 percent. The average score for subjective evaluation was 14.5 of 20. The objective score was 13.9 of 20. The results were significantly different depending on the aesthetic subunit of the face. The best results were achieved in the malar (89 percent good results) and lateral cheek areas (84 percent good results). The poorest results were registered for the lower and upper lip areas (34 percent and 31 percent good results, respectively). Minor complications were observed in 3 percent of the cases.

Conclusions: Fat tissue grafting is a simple, efficient, and reproducible technique for restoration of facial volumes. In the absence of functional disorders, it is the authors’ first choice in the decision-making process for the treatment of facial soft-tissue deficiencies.

Lyon, France

From the Department of Plastic and Reconstructive Surgery, Edouard Herriot Hospital.

Received for publication October 17, 2008; accepted February 9, 2009.

Presented at the 14th Congress of the International Plastic Reconstructive and Aesthetic Society, in Berlin, Germany, June 26 through 30, 2007, and the International Symposium on Fat Injection, Fondazione G. Sanvenero Rosselli, in Milan, Italy, September 15, 2007.

Disclosure: None of the authors has any financial interests in this research project or in any of the techniques or equipment used in this study.

Ali Mojallal, M.D., Department of Plastic and Reconstructive Surgery, Edouard Herriot Hospital, Pavillion U, Place d’Arsonval, 69003 Lyon, France,

©2009American Society of Plastic Surgeons