December 27, 2016
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Orthognathic combined with autologous fat transfer improves facial symmetry

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Combining orthognathic surgery with autologous fat injection improves facial symmetry and is a safe and simple procedure, according to study results published in Plastic and Reconstructive Surgery.

Fifteen patients were treated with the combined procedure between January 2003 and 2005. Photographs were taken preoperatively and postoperatively to calculate lower facial symmetry indices. The researchers used an 18-gauge blunt-tipped cannulae for most fat transfers. The lower abdomen was the preferred donor site for all patients.

Interface area divided by a larger hemi-face area multiplied by 100 calculated the mean lower face symmetry index. Mean preoperative facial symmetry index was 11.15 ± 6.91. At 6 months follow-up, the mean lower facial symmetry index of 4.41 ± 2.6 was significantly better (P = .001).

The researchers noted that selection of the fat injection recipient sites is an important factor in obtaining quality results, with the maxillofacial area offering high vascularity. The patients in the study were injected into several areas, including the temple, orbit, eyelids, malar and submalar areas, cheek, lips, chin, mandibular borders and mandibular angles.

“The operative sequence that we employ is orthognathic surgery and genioplasty first, then fat harvest,” the researchers wrote. “We do not harvest fat until the orthognathic surgical maneuvers have been completed, in order to reduce the time period between fat harvest and fat injection (to maximize graft survival). Once the orthognathic maneuvers have been completed (but before wound closure), we harvest the fat, perform the fat transfers, and then close the orthognathic surgery wounds. If fat transfer is delayed until after the orthognathic surgery wounds are closed, facial swelling can start interfering with judgments of facial soft tissue asymmetry.” – by Talitha Bennett

Disclosure: Healio.com/Aesthetics was unable to determine the researchers’ relevant financial disclosures at the time of publication.