Structural fat grafting: facial volumetric restoration in complex reconstructive surgery

The authors overview the application of structural fat grafting (SFG) in the management of volumetric deficit in the maxillofacial area. Structural fat grafting was introduced as a way to improve facial aesthetics and in recent years has evolved into applications in craniomaxillofacial reconstructive surgery.

A retrospective cohort study population was composed of patients grafted with autologous fat referred to our department from February 2005 to July 2009. Each patient was operated on with SFG technique according to Coleman. Subjects were screened to these possessing an atrophy of facial soft tissues after trauma, tumor resection, congenital deformities and clefts, Parry-Romberg and scleroderma, orbital and periorbital surgery, facial palsy, burns, and scars.

Forty-seven patients (27 females and 20 males) with a mean age of 38 years (minimum, 15 years; maximum, 71 years) were enrolled in the current study. The mean postoperative follow-up was 14 months. A total of 548 sites were grafted into 47 patients: malar, n = 103; nasolabial fold, n = 82; lip, n = 86; eyebrow, n = 32; jaw line, n = 18; philtrum, n = 19; forehead, n = 33; temple, n = 34; eyelid, n = 70; chin, n = 16; cheek, n = 25; nose, n = 23; and neck scar, n = 7. Each patient was operated on 1.6 times, and 11.6 was the average number of grafted sites.

The authors have performed 548 procedures of SFG in 47 patients with good results as well as improvement in facial morphology, function, shape, and volume and improvement in the patients' appearance.