title: Autologous fat transfer to the cranio-maxillofacial region: updates and controversies.
abstract: BACKGROUND
  Autologous fat grafts have gained popularity among Cranio-Maxillofacial surgeons within the past years. Most publications report favourable outcomes but lack quantifiable evidence of graft survival.
  
  
  OBJECTIVE
  To assess autologous fat transfer for facial asymmetry, and review the literature focusing on current indications, techniques, complications, fat survival and patient satisfaction.
  
  
  METHODS
  Nine patients presented facial asymmetry due to onchological resection, congenital anomaly, or craniofacial traumatism. A total of 11 autologous fat transfers were performed. Four procedures followed the Coleman technique; in the other seven procedures, fat centrifugation was obviated.
  
  
  RESULTS
  No significant complications derived. Progressive volumetric decrease was evidenced for up to 6 months after surgery. A second procedure was performed in two patients. No clinical differences in cosmetic outcomes or graft survival were observed between centrifuged and non-centrifuged grafts. Patients reported high satisfaction.
  
  
  CONCLUSIONS
  Facial recontouring with autologous fat transfer restores volumetric defects with high patient satisfaction. The scientific literature offers inconsistent results. The authors did not find clinical differences between centrifuged and non-centrifuged grafts. Volume gain may result from induced fibrosis, inflammation and native adipocyte growth or differentiation. The heightened interest in these procedures should instigate further investigation to refine surgical procedures and improve predictability.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Hospital Clínico Universitario of Valencia, 17 Blasco Ibáñez Avenue, 46010 Valencia, Spain. raquelguijarro@comv.es
authors.forename: Raquel
authors.initials: R
authors.lastname: Guijarro-Martínez
authors.forename: Luis
authors.initials: L
authors.lastname: Miragall Alba
authors.forename: Mariano
authors.initials: M
authors.lastname: Marqués Mateo
authors.forename: Miguel
authors.initials: M
authors.lastname: Puche Torres
authors.forename: José Vicente
authors.initials: JV
authors.lastname: Pascual Gil
mesh_terms: D034861:Abdominal Wall / Q000601:surgery; D000273:Adipose Tissue / Q000637:transplantation*; D000293:Adolescent; D000328:Adult; D002498:Centrifugation; D003357:Cosmetic Techniques; D005145:Face / Q000601:surgery; D005146:Facial Asymmetry / Q000601:surgery*; D005260:Female; D006085:Graft Survival; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications; D013396:Suction; D020858:Tissue and Organ Harvesting / Q000379:methods