title: Complications of fat grafts growth after weight gain: report of a severe diplopia.
abstract: A 47 years old woman underwent autologous fat grafting to treat a 5×4 cm depression of the lower lid and the upper cheek secondary resection of squamous cell carcinoma and subsequent coverage by full thickness skin graft. 20 mL of autologous fat were harvested from lower abdomen, centrifuged and injected subcutaneously. The patient then gained a total of 15 kg over a period of 24 months. Eye dystopia developed while the grafted area became convex. MRI confirmed subcutaneous fat mass going to the orbital floor through the inferior septal defect. The fat excess was removed through a trans-conjonctival approach allowing for a progressive regression of diplopia after 2 months while the oedema reduced. The overall follow up from the resection-coverage and last examination was 5 years. In this case with a context of noticeable weight gain, the growth of a fat graft trapped between a sclerous plane and the eye, that penetrated the orbital cavity through a septal defect led have led to exophthalmos, ocular dystopia and diplopia. Systematic overcorrection in autologous fat grafting should be prevented, especially in functional areas and on low body mass index patient that might gain weight.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Hospital Europen Georges Pompidou (HEGP), Assistance Publique-Hopitaux de Paris, and Faculté de médecine, Université René Descartes, Paris 5, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Duhoux
authors.forename: Mehdi
authors.initials: M
authors.lastname: Chennoufi
authors.forename: Laurent
authors.initials: L
authors.lastname: Lantieri
authors.forename: Mikael
authors.initials: M
authors.lastname: Hivelin
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery; D002610:Cheek / Q000601:surgery; D004172:Diplopia / Q000209:etiology* / Q000503:physiopathology; D005143:Eyelids / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012086:Reoperation / Q000379:methods; D018570:Risk Assessment; D012720:Severity of Illness Index; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery; D016038:Skin Transplantation / Q000379:methods; D050151:Subcutaneous Fat / Q000254:growth & development* / Q000601:surgery / Q000637:transplantation*; D016896:Treatment Outcome; D015430:Weight Gain