Background: Hemifacialmicrosomia patients usually
complain from facial lower two thirds hypotrophies more than
they do from their dental malocclusion. Over the past few
years with the widespread of facial fat grafting, they have
been barely accepting treatment with the heavy-to-patient
conventional orthognathic surgery that combines Le Fort I,
Bilateral Sagittal Split Osteotomy (BSSO) and genioplasty.
Aim of Work: This presentation aims to support fat grafting
for facial contouring as an alternative or supplement to
maxillofacial osteotomies in patients suffering first and second
brancheal arch syndrome.
Case Presentation: Nine adult patients with hemifacialmicrosomia
underwent fat grafting to the face; 5 patients
without any maxillofacial osteotomy, 3 patients in combination
with the anterior segmental tilting osteotomy and one patient
after the traditional interruptive bi-maxillary surgery.Grafted
fat alone or combined with maxillofacial osteotomies improved
facial contours and symmetry. After few years and on gaining
extra body weight, three patients were retouched through
liposuction of the bulging recipient areas and the aspirated
fat was re-grafted to other areas [1].
Conclusion: Fat grafting to the face treating defective
contours of hemifacialmicrosomia cases may represent the
acceptable alternative to the interruptive bimaxillary osteotomies.
Its association with the malocclussion-corrective simpler
segmental or genioplasty osteotomies adds to facial contouring
and symmetry.