Isolated Fat Grafting for Reconstruction of Lower Face Volumetric Asymmetry in Skeletally Immature Patients: A Clinical Outcome Study

Ann Plast Surg. 2019 Nov;83(5):529-537. doi: 10.1097/SAP.0000000000001934.


Background: The purpose of this study was to assess the objective and subjective outcomes of lower face volumetric (contour) asymmetry correction with isolated fat grafting in skeletally immature patients.

Methods: A prospective analysis was conducted of skeletally immature patients (n = 73) with craniofacial microsomia and Parry-Romberg syndrome who underwent isolated fat grafting (with no previous or concomitant bone surgery) using anatomical surgical principles (facial subunits and fat compartments) for the reconstruction of lower face volumetric asymmetry. Objective ultrasound and photogrammetric lower face symmetry analyses were blindly performed preoperatively and at 3 and 12 months postoperatively. A panel assessment of blinded surgical professionals and laypersons was also obtained to grade the subjective lower face symmetry.

Results: There were significant (all P < 0.05) postoperative objective and subjective lower face symmetry enhancements (preoperative < postoperative) after isolated fat grafting, with no differences (all P > 0.05) between 3 versus 12 months' postoperative comparisons.

Conclusions: Growing patients with unilateral lower face volumetric asymmetries presented with improvement of objective and subjective symmetry after a single isolated fat grafting procedure.

MeSH terms

  • Adipose Tissue / transplantation*
  • Child
  • Child, Preschool
  • Face / pathology
  • Face / surgery
  • Facial Asymmetry / surgery*
  • Facial Hemiatrophy / surgery*
  • Female
  • Goldenhar Syndrome / surgery*
  • Humans
  • Male
  • Organ Size
  • Prospective Studies
  • Reconstructive Surgical Procedures / methods*
  • Treatment Outcome