Does Fat Grafting Influence Postoperative Edema in Orthognathic Surgery?

J Craniofac Surg

*Yale School of Medicine †Division of Oral and Maxillofacial Surgery ‡Division of Plastic and Reconstructive Surgery, Yale University School of Medicine, Yale-New Haven Hospital §Craniofacial Center, Yale University School of Medicine, Plastic and Craniomaxillofacial Surgery, New Haven, CT.

Published: November 2017

AI Article Synopsis

  • The study investigates the impact of autologous fat grafting on facial swelling after orthognathic surgery, focusing on how fat grafting affects the size and duration of facial edema.
  • Using a retrospective analysis of three-dimensional imaging data, the researchers compared outcomes between patients who received fat grafts and those who did not, assessing changes in facial volume post-surgery.
  • Results indicated that while all patients experienced a significant reduction in swelling over 12 weeks, those who had fat grafting showed a faster decrease in swelling, suggesting that fat grafting can help mitigate postoperative edema more effectively.

Article Abstract

Purpose: Autologous fat grafting is a useful adjunctive procedure to orthognathic surgery and may also confer anti-inflammatory properties. The purpose of this study is to answer the clinical question: among patients undergoing orthognathic operations, what are the effects of fat grafting on facial edema (magnitude, duration, and rate of decrease)?

Methods: A retrospective cohort study was performed. Three-dimensional photos (Canfield, Fairfield, NJ) from preoperative and a series of postprocedure time-points were analyzed. The data set was divided into a fat-grafted cohort and a non-fat-grafted cohort and later analyzed using paired and unpaired t tests and linear regressions to determine significant correlations.

Results: One hundred sixteen pre- and postoperative three-dimensional photo data sets were included. The sample included 29 subjects. The facial volume was analyzed both overall and comparing each subgroup (orthognathic vs. orthognathic + fat grafting group). Postoperative facial volume increase averaged 23.7% for the entire cohort (FG and nFG). By week 12, the swelling decreased about 62% from baseline. In all patients, there was a statistically significant decrease in facial volume with time. In the fat-grafted group, despite adding volume, the facial volume was equal to the non-fat-grafted group at week 1, yet the rate of decrease was faster through week 12.

Conclusion: The majority of postoperative facial edema decreases by 12 weeks following orthognathic surgery. In this cohort of patients, despite the addition of volume, concurrent fat grafting lessened postoperative edema, and led to a greater magnitude and speed of resolution.

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Source
http://dx.doi.org/10.1097/SCS.0000000000003821DOI Listing

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