Management of Facial Asymmetry with Combination of Orthognathic Surgery and Autologous Fat Transfer

Facial asymmetry is a challenge for craniofacial surgeons to correct. Our center currently uses three dimensional (3-D) surgical designs by combining cone-beam computed tomography scans and 3-D photographs (3dMD, Atlanta, Ga). Computer assisted surgical designs can help the surgeon achieve facial skeletal symmetry [1]. However, even if skeletal symmetrisation can be achieved, such patients almost invariably demonstrate some soft tissue discrepancy that persists after surgery. Autologous fat grafting is a minimally invasive procedure that is useful for correcting soft tissue deficiencies. Autologous fat transfer has many advantages: The graft volume that takes is long lasting. Large volumes of fat are graftable, including in successive grafting sessions. The surgical wounds are insignificant in size, being punctures, and can be strategically hidden. Minimal complication rates and minimal donor site morbidity. Fat grafts are entirely biocompatible. The volumisation effect of fat grafting can improve the overlying skin texture. Relatively short operation time. The materials used during the procedure are relatively inexpensive. Donor sites are readily available. Fat grafting can be combined with other surgical procedures such as face lift, orthognathic surgery and others [2].