Cabrejo Raysa, Sawh-Martinez Rajendra, Steinbacher Derek M
Section of Plastic Surgery, Department of Surgery, Yale Medical School, New Haven, CT.
J Craniofac Surg. 2019 May/Jun;30(3):698-702. doi: 10.1097/SCS.0000000000005287.
Autologous fat grafting concurrent with orthognathic surgery is a powerful adjunctive aesthetic tool, and has been shown to have anti-inflammatory properties in prior studies. The purpose of this study is to evaluate the effect of fat grafting on postoperative edema following orthognathic surgery, and also consider the impact of age and BMI.
A retrospective cohort study was performed. Three-dimensional photos (Canfield, Fairfield, NJ) from a series of postprocedure time-points were analyzed using Geomagic Studio 2013 (3D Systems, Morrisville, NC). An unstructured covariance linear mixed model was created to analyze the effect and extent of the effect of age, BMI, and fat using SPSS Statistics 24.0 (IBM, Armonk, NY).
One hundred thirty postoperative three-dimensional pictures were analyzed, from 31 patients. The linear mixed model demonstrates that the fat injected (P<0.001), age (P=0.001), and BMI (P<0.001) are significant factors in the postoperative volume. Age and BMI increase postoperative edema by 3.63 cm per year and 14.60 cm per kg/m, respectively. Fat injected reduces postoperative edema by 8.72 cm per 1 cc injected.
Increasing age and BMI lead to greater postoperative edema (3.88 cm per year and 14.60 cm per kg/m, respectively). Fat grafting concurrent with orthognathic surgery reduces postoperative edema by 8.72 cm per 1 cc injected, and hastens return to steady state. This impact is more profound in patients with a greater age and BMI.
正颌手术同期进行自体脂肪移植是一种强大的辅助美容手段,先前研究已表明其具有抗炎特性。本研究旨在评估脂肪移植对正颌手术后水肿的影响,并探讨年龄和体重指数(BMI)的作用。
进行一项回顾性队列研究。使用Geomagic Studio 2013(3D Systems,北卡罗来纳州莫里斯维尔)分析一系列术后时间点的三维照片(Canfield,新泽西州费尔菲尔德)。使用SPSS Statistics 24.0(IBM,纽约州阿蒙克)创建非结构化协方差线性混合模型,以分析年龄、BMI和脂肪的影响及影响程度。
分析了31例患者的130张术后三维照片。线性混合模型显示,注入的脂肪量(P<0.001)、年龄(P=0.001)和BMI(P<0.001)是术后体积的重要影响因素。年龄和BMI分别使术后水肿每年增加3.63厘米和每千克/米增加14.60厘米。每注入1立方厘米脂肪可使术后水肿减少8.72厘米。
年龄增长和BMI增加会导致更大程度的术后水肿(分别为每年3.88厘米和每千克/米14.60厘米)。正颌手术同期进行脂肪移植可使术后水肿每注入1立方厘米减少8.72厘米,并加速恢复至稳定状态。这种影响在年龄较大和BMI较高的患者中更为显著。