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Temporal Fat Grafting in Children With Craniofacial Anomalies
Artur Fahradyan1, Pedram Goel2, Madeline Williams3
1From the Division of Plastic and Reconstructive Surgery.
Insights
Fat grafting effectively treats temporal hollowing in children with craniofacial anomalies, showing no complications. This procedure offers moderate to significant aesthetic improvement for pediatric patients.
Area of Science:
- Plastic Surgery
- Pediatric Surgery
- Craniofacial Surgery
Background:
- Temporal fat hollowing is a common issue in children with craniofacial anomalies.
- Fat grafting is frequently used as an adjunct procedure to address this.
- Assessing surgical and aesthetic outcomes is crucial for treatment efficacy.
Purpose of the Study:
- To evaluate the surgical and aesthetic results of fat grafting for temporal hollowing in pediatric patients.
- To determine the safety and effectiveness of this reconstructive technique.
Main Methods:
- Retrospective review of patients undergoing temporal fat grafting at a pediatric craniofacial center.
- Surgical outcomes assessed by complication rates (intraoperative and 30-day postoperative).
- Aesthetic outcomes evaluated by independent investigators using standardized grading scales for hollowing severity and improvement.
Main Results:
- Forty-three patients were included, with a mean age of 9.9 years.
- No intraoperative or postoperative complications were reported.
- A mean aesthetic improvement score of 2.9 (moderate to significant) was observed, though syndromic status negatively impacted outcomes.
Conclusions:
- Fat grafting is a safe and effective treatment for temporal hollowing in children with craniofacial anomalies.
- The procedure yields positive aesthetic results with minimal complications.
- Further research may explore factors influencing outcomes in syndromic patients.
Background:
Fat grafting is a common adjunct procedure used to treat temporal fat hollowing in children with craniofacial anomalies. The goal of this study was to assess the surgical and aesthetic outcomes of this procedure.
Methods:
We retrospectively reviewed patients who underwent temporal fat grafting at a single tertiary pediatric craniofacial center. The surgical outcome was assessed based on intraoperativeand 30-day postoperative complication rates. The aesthetic outcome was assessed by 3 independent investigators using a 3-point grading scale for preoperative temporal hollowing severity (1 = mild, 2 = moderate, 3 = severe) and a 5-point scale for postoperative improvement (0 = no, 1 = mild, 2 = moderate, 3 = significant, and 4 = complete improvement).
Results:
Forty-three patients met inclusion criteria. Twenty-seven (63%) were male, 39 (91%) had a history of craniosynostosis, and 18 (42%) had associated syndromes. The mean age at fat grafting was 9.9 years (2.7-20.4, SD = 5.5) with an average follow-up time of 1.6 years (0-5.8, SD = 1.8). The average volume of fat grafted was 8.6 mL (0-30, SD = 5.9) to the right temporal region and 8.6 mL (0-30, SD = 5.8) to the left. There were no intraoperative or postoperative complications. The mean improvement score was 2.9 (1-4, SD = 0.7), demonstrating that most patients experienced moderate to significant improvement. Multiple linear regression analysis demonstrated that syndromic status had a negative impact on the aesthetic outcome (P < 0.001).
Conclusions:
These findings demonstrate that fat grafting is an effective method to treat temporal hollowing in children with craniofacial anomalies with no perioperative complications.
