Facial Contour Symmetry Outcomes after Site-Specific Facial Fat Compartment Augmentation with Fat Grafting in Facial Deformities.

BACKGROUND

The purposes of this study were to evaluate facial symmetry after the first fat grafting session in patients with unilateral facial contour deformities and to identify independent predictors of 12-month postoperative facial symmetry.

METHODS

A prospective analysis was conducted of consecutive patients (n = 167) that underwent fat grafting to restore facial contour symmetry. Computerized photogrammetric facial symmetry analyses were performed. Bivariate and multivariate analyses were executed to identify independent predictors of 12-month postoperative facial symmetry.

RESULTS

There were significant (all p < 0.05) postoperative facial symmetry enhancements (preoperative less than postoperative) after facial fat grafting. The facial symmetry was maintained (all p > 0.05) from 3 to 12 months postoperatively, with a 12-month facial symmetry of 91.2 ± 6.9 percent (ranging from 79.8 to 99.3 percent). Sixty-six complementary facial fat grafts (39.5 percent) were performed for residual asymmetry. Age, Parry-Romberg syndrome, previous facial bone surgery at the site that received fat grafting, and injected volume were independently negative (all p < 0.05) predictors of 12-month postoperative facial symmetry.

CONCLUSION

A significant improvement of facial contour symmetry was obtained after the first facial fat grafting session, but a subset of patients required complementary fat graft procedures for residual asymmetry, with age, Parry-Romberg syndrome, previous bone surgery, and injected volume affecting postoperative facial contour symmetry.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.