Rehabilitation of irradiated head and neck tissues by autologous fat transplantation.
BACKGROUND
Treatment of head and neck cancers allows good carcinologic results but induces aesthetic and functional sequelae. Autologous fat transplants have been used to correct aesthetic defects since the past century and exhibit many of the qualities of the ideal filler. Results reported here stem from experiences from 2000, with abdominal fat grafting in 11 patients who were referred to the authors' center for aesthetic subcutaneous or submucous head and neck reconstruction after radiotherapy.


METHODS
Abdominal fat tissues were harvested, and injection into host sites was performed in a manner similar to that of the lipostructure technique described by Coleman. The postoperative follow-up periods ranged from 2 to 88 months (mean, 39.9 months). Clinical monitoring of the patients was carried out. Additional pathologic study was performed on irradiated tissues surrounding the scar and on abdominal fat and treated tissues.


RESULTS
No surgical procedure complications occurred. For all cases, except for one patient, the rehabilitation was aesthetic and functional. The quality of life of the patients was improved. The pathologic data highlighted a decrease in irradiated morphologic patterns characterized by an absence of necrotic areas and a high vascular network density associated with a normal histologic structure.


CONCLUSIONS
Fat tissues can be successfully transplanted into irradiated areas, inducing both aesthetic and functional improvement. The cellular and/or tissular mechanisms underlying these changes need further investigation.
Phulpin
Bérengère
B
Vandoeuvre les Nancy and Nancy, France From the Head and Neck Surgery Unit, Oncologic Surgery Department, and the Tumor Biology Unit, Centre Alexis Vautrin, the Oral Surgery Department, Odontological Faculty, and the Laboratory of Surgery School-INSERM U684, Faculty of Medicine, UHP-Nancy.
Gangloff
Pierre
P
Tran
Nguyen
N
Bravetti
Pierre
P
Merlin
Jean-Louis
JL
Dolivet
Gilles
G