Correction of whistle deformity using autologous free fat grafting: first results of a pilot study and review of the literature

Baum, Sven Holger; Rieger, Gunnar; Pförtner, Roman; Mohr, Christopher

doi:10.1007/s10006-017-0648-8

Cited by 14 publications

(13 citation statements)

References 39 publications

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“…Of which, 359 were excluded: 38 papers were not in English, 41 were review articles, 279 articles were not reporting recipient site complications, 1 was not on human subjects. A total of 103 [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 ,…”

Section: Resultsmentioning

confidence: 99%

Facial Fat Grafting (FFG): Worth the Risk? A Systematic Review of Complications and Critical Appraisal

Schiraldi

Sapino

Meuli

et al. 2022

JCM

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Autologous fat is ideal soft tissue filler. It is easily accessible, biocompatible, cheap, and it provides both volume augmentation and skin quality improvement. Fat grafting has been used since 1893, but it has only gained widespread popularity since the development of modern liposuction by Colemann and Illouz in the 1980s. Every year more than half a million facial fat grafting procedures are carried out worldwide and the trend is rapidly increasing. Overall, general complications associated with facial fat grafting are assumed to be around 2%. Is that true? Material and Methods: Until July 2021, a systematic search of the literature was performed interrogating PubMed search engines. The following algorithm was used for the research: (fat graft OR lipofilling) AND face AND complications. Exclusion criteria applied hierarchically were review articles, not reporting recipient site complications; not in English and paediatric population. Abstracts were manually screened by LS, GS, JM and PDS separately and subsequently matched for accuracy. Pertinent full-text articles were retrieved and analysed and data were extracted from the database. The flow chart of article selection is described following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results: In total, 462 papers were identified by PubMed search. A total of 359 were excluded: 38 papers were not in English, 41 were review articles, 279 articles did not report recipient site complications and 1 was not on human subjects. Average complication rate ranged from 1.5% to 81.4%. A total of 298 adverse events were identified: 40 (13.4%) intravascular injections, 13 (4.3%) asymmetry, 57 (19.1%) irregularities, 22 (7.4%) graft hypertrophy, 21 (7%) fat necrosis, 73 (24.5%) prolonged oedema, 1 (0.3%) infection, 6 (2%) prolonged erythema, 15 (5%) telangiectasia and 50 (16.8%) cases of acne activation. Conclusions: FFG related side effects could be resumed in three categories: severe, moderate, and minor. Severe (13.4%) side effects such as intravascular injection or migration require neurological or neurosurgical management and often lead to permanent disability or death. Moderate (38.3%) side effects such as fat hypertrophy, necrosis, cyst formation, irregularities and asymmetries require a retouch operation. Minor (48.3%) side effects such as prolonged oedema or erythema require no surgical management. Despite the fact that the overall general complication rate of facial fat grafting is assumed to be around 2%, the real complication rate of facial fat grafting is unknown due to a lack of reporting and the absence of consensus on side effect definition and identification. More RCTs are necessary to further determine the real complication rate of this procedure.

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Section: Resultsmentioning

confidence: 99%

Facial Fat Grafting (FFG): Worth the Risk? A Systematic Review of Complications and Critical Appraisal

Schiraldi

Sapino

Meuli

et al. 2022

JCM

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“…There is a growing interest in the use of minimally invasive procedures. The most common less invasive procedures for secondary lip repair in the cleft population are the local tissue rearrangement procedures (Jackson et al, 2020) or free fat grafting (Baum et al, 2017) or combination of both. Further, there is a report of the use of hyaluronic acid (HA) fillers for the correction of residual lip asymmetry in a patient after cleft lip surgery with favorable results (Schweiger et al, 2008; Stolic et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

Aesthetic Enhancement of the Vermilion Using Dermofat Graft in Patients With Cleft Lip Deformity

Chung

deLeeuw

Lin

et al. 2021

The Cleft Palate Craniofacial Journal

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Background: There is an increasing patient expectation for better esthetics, manifesting through anatomical harmony, projection, and volume of the upper lip relative to the lower lip, in patients with cleft deformity. The aim of this study is to investigate the outcome of vermilion augmentation using autologous dermofat graft (DFG) to enhance the lip using both quantitative and qualitative assessment. Methods: Patients with secondary cleft lip deformity who received the surgical treatment in our institution from 2015 to 2018 were recruited. Panel assessment was performed on standardized preoperative and postoperative digital photographs. A patient questionnaire was used for the reported outcome. Image processing and analyses were applied to measure the lip change. Statistical analyses were performed. Results: A total of 91 patients were included. The mean age at operation was 22.7 years, and postoperative follow-up was 3.6 years. There were no complications in the study group. The panel assessment showed significant improvement ( P < .00001) on upper lip vermilion in both frontal and lateral profile views. Ninety-five percent of patients reported improvement of the upper lip projection and volume. Quantitative image analysis showed an increase in the upper lip vermilion ratio in 97% of the cases in frontal views and improvement of the vermilion projection in 87% of the cases in the superimposed lateral views. Conclusions: The use of DFG is an effective and reproducible method for vermilion augmentation and aesthetic enhancement in patients presenting with upper lip insufficiency relative to the lower lip.

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“…Concerns, however, include variable graft take, graft displacement, and persistent firmness or lumpiness of the upper lip (Chen et al, 1995; Rohrich et al, 2000; Stal and Hollier, 2002; Patel and Hall, 2004; Staebel and Verheyden, 2009; Wakami et al, 2010; Lee and Koh, 2012; Tabrizi et al, 2015). After CL repair, scarring at the site of notching can prevent adequate lip expansion and compromise of the vascular bed after graft placement, resulting in poor graft position and graft take (Eremia and Newman, 2000; Stal and Hollier, 2002; Duskova and Kristen, 2004; Zellner et al, 2015; Baum et al, 2017; Jones et al, 2017; Koonce et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

“…Correction of vermillion irregularities can involve both invasive and minimally invasive techniques or a combination. Invasive techniques include tissue rearrangement using Z-plasties, V-Y advancement, W-plasty, and a variety of local mucosal or myomucosal flaps, as well as more distant flaps of vermillion and mucosa from the lower lip (Kapetansky, 1971; Wagner and Newman, 1994; Gur and Zuker, 2000; Stal and Hollier, 2002; de Chalain and Black, 2004; Grewal et al, 2009; Wakami et al, 2010; Baum et al, 2017; Chung and Lo, 2017). Dermal fat grafting, autologous fat injections, implantation of acellular dermal matrix, and temporoparietal fascia have also been described for this purpose (Chen et al, 1995; Patel and Hall, 2004; Lee and Koh, 2012).…”

Section: Introductionmentioning

confidence: 99%

Precision Dermal Fat Grafting for Vermillion Deficiencies in Patients With Unilateral and Bilateral Cleft Lip

Jackson

Lee

Nikovina

et al. 2019

The Cleft Palate Craniofacial Journal

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Objective: Deficiencies of the upper lip vermilion occur with some frequency following repair of unilateral and bilateral clefts of the lip and can compromise the aesthetic outcome. The presence of dense scar tissue within the lip at the cleft site as well as intrinsic vermillion deficiencies can make long-lasting correction of this deformity challenging. We describe a technique to address vermillion deficiencies after cleft lip repair. Design: A novel lip augmentation technique for correction of residual vermilion deficiencies after unilateral and bilateral cleft lip repair is presented. This technique combines precise placement of a contoured dermal fat graft with local tissue (V-Y) rearrangement. Conclusion: In our experience, this method of lip augmentation following either unilateral or bilateral cleft lip repair can restore upper lip vermillion symmetry and provide predictable and durable results in patients with mild to severe vermillion deficiency.

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Correction of whistle deformity using autologous free fat grafting: first results of a pilot study and review of the literature

Abstract: Autologous free fat graftings for reconstruction of whistle deformity represent a reliable method with a low complication rate. However, the resorption rate is unpredictable. If necessary, several autologous fat transplantations should be conducted at an interval of at least 6 months.

Cited by 14 publications

References 39 publications

Facial Fat Grafting (FFG): Worth the Risk? A Systematic Review of Complications and Critical Appraisal

Facial Fat Grafting (FFG): Worth the Risk? A Systematic Review of Complications and Critical Appraisal

Aesthetic Enhancement of the Vermilion Using Dermofat Graft in Patients With Cleft Lip Deformity

Precision Dermal Fat Grafting for Vermillion Deficiencies in Patients With Unilateral and Bilateral Cleft Lip

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