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

Abstract

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.