From the Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital.
Plast Reconstr Surg. 2019 Mar;143(3):823-835. doi: 10.1097/PRS.0000000000005389.
The purposes of this study were to (1) assess complementary fat graft outcomes, (2) compare initial and complementary fat graft retention rates, and (3) evaluate the influence of different postoperative time points (3, 6, and 12 months after the initial procedure) for performing complementary fat grafting on fat graft outcomes.
A prospective analysis was conducted on patients with unilateral craniofacial contour deformities (n = 115) who underwent initial and complementary fat grafting. Complementary fat grafting was performed 3, 6, or 12 months after the initial fat grafts. Standardized ultrasonographic craniofacial soft-tissue thickness measurements were performed blindly to determine the initial and complementary fat graft retention rates at 1, 3, 6, and 12 months after surgery.
A significant (p < 0.05) reduction of fat graft retention was observed within the first 3 postoperative months, and a maintenance of retention (p > 0.05) was observed at 3 through 12 months after surgery for both initial and complementary procedures. No significant (p > 0.05) differences were observed in comparative analysis of the postoperative time points. Complementary retention rates were significantly (p < 0.05) superior to initial retention rates at 3, 6, and 12 months after surgery. Complementary retention rates at 3, 6, and 12 months after surgery were significantly (p < 0.05) superior to initial retention rates for patients aged 18 years or older, those with Parry-Romberg syndrome, those who had undergone previous craniofacial bone surgery, and those with a recipient site at the forehead unit.
The complementary fat graft retention rates were superior to the initial retention rates, with no significant differences among the postoperative time points for performing complementary procedures.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.
本研究旨在：（1）评估补充脂肪移植的结果；（2）比较初始和补充脂肪移植的保留率；（3）评估在初始手术 3、6 和 12 个月后进行补充脂肪移植对脂肪移植结果的影响。
对 115 例单侧颅面轮廓畸形患者进行前瞻性分析，这些患者均接受了初始和补充脂肪移植。在初始脂肪移植后 3、6 或 12 个月进行补充脂肪移植。采用标准化的超声颅面软组织厚度测量方法，在术后 1、3、6 和 12 个月，盲法确定初始和补充脂肪移植的保留率。
在术后前 3 个月，脂肪移植的保留率显著下降（p < 0.05），而在术后 3 至 12 个月，初始和补充手术的保留率均保持不变（p > 0.05）。在术后时间点的比较分析中，未观察到显著差异（p > 0.05）。补充保留率在术后 3、6 和 12 个月均显著高于初始保留率（p < 0.05）。在术后 3、6 和 12 个月，对于年龄在 18 岁或以上的患者、患有 Parry-Romberg 综合征的患者、先前接受过颅面骨手术的患者以及在前额部位接受移植的患者，补充保留率显著高于初始保留率（p < 0.05）。
补充脂肪移植的保留率优于初始保留率，且在进行补充手术的术后时间点之间无显著差异。
临床问题/证据水平：治疗性，II 级。
