Does Fat Grafting Influence Postoperative Edema In Orthognathic Surgery?
Raysa Cabrejo, BS, Raj Sawh-Martinez, MD, Derek M. Steinbacher, MD.
Yale, New Haven, CT, USA.
PURPOSE: Autologous fat grafting is a useful adjunctive procedure to orthognathic surgery and may also confer anti-inflammatory properties. The purpose of this study is to answer the clinical question: among patients undergoing orthognathic operations, what are the effects of fat grafting on facial edema (magnitude, duration and rate of decrease)?
METHODS: A retrospective cohort study was performed. 3D photos (Canfield, Fairfield NJ) from preoperative and a series of post-procedure time-points were analyzed. The data set was divided into a fat grafted cohort and a non fat grafted cohort and later analyzed using paired and unpaired t-tests and linear regressions to determine significant correlations.
RESULTS: Hundred and sixteen pre-and post-operative 3D photo data sets were included. The sample included 29 subjects. The facial volume was analyzed both overall and comparing each subgroup (orthognathic versus orthognathic + fat grafting group). Post-operative facial volume increase averaged 23.7% for the entire cohort (FG and nFG). By week twelve, the swelling decreased about 62% from baseline. In all patients, there was a statistically significant decrease in facial volume with time. In the fat-grafted group, despite adding volume, was equal to the non-fat grafted group at week 1, yet the rate of decrease was faster with fat grafting at week 12.
CONCLUSION: The majority of post-operative facial edema decreases by 12 weeks following orthognathic surgery. In this cohort of patients, despite the addition of volume, concurrent fat grafting lessens postoperative edema, and leads to a greater magnitude and speed of resolution.
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