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Fat Grafting in Managing Craniofacial Deformities

Denadai, Rafael, M.D.; Raposo-Amaral, Cesar Augusto, M.D.; Raposo-Amaral, Cassio Eduardo, M.D., Ph.D.

Plastic and Reconstructive Surgery: May 2019 - Volume 143 - Issue 5 - p 1447–1455
doi: 10.1097/PRS.0000000000005555
Pediatric/Craniofacial: Original Articles
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Background: The successful correction of craniofacial contour deformities remains a major challenge in plastic surgery. This article reviews important concepts and strategies for craniofacial fat grafting and presents a SOBRAPAR Hospital algorithm focused on achieving craniofacial contour symmetry as early as possible without compromising function.

Methods: Principle-based methods (i.e., anatomical facial fat compartments, fluid accommodation model, multistage site-specific craniofacial fat grafting, and structural fat-grafting technique) were itemized into an algorithm to aid in planning and selecting the best surgical approach (i.e., bone and/or soft tissue procedures) in order to obtain craniofacial contour symmetry.

Results: The treatment plan and choice of surgical technique implemented to address bone and/or or soft tissue deformities were determined by specific diagnosis, patient age at presentation, and functional status. Bony reconstruction in skeletally immature patients is reserved solely for those patients with functional issues.

Conclusion: By adopting principle-based methods and fat compartment theory, we are able to achieve craniofacial contour symmetry and aesthetically pleasing outcomes without compromising function.

Campinas, São Paulo, Brazil

From the Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital.

Received for publication May 4, 2018; accepted September 11, 2018.

Disclosure:The authors have no financial interest to declare in relation to the content of this article.

A “Hot Topic Video” by Editor-in-Chief Rod J. Rohrich, M.D., accompanies this article. Go to and click on “Plastic Surgery Hot Topics” in the “Digital Media” tab to watch.

Cassio Eduardo Raposo-Amaral, M.D., Ph.D., Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Av. Adolpho Lutz, 100, Caixa Postal: 6028, Campinas, São Paulo 13084-880, Brazil,, Instagram: @cassio.raposo

©2019American Society of Plastic Surgeons
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