Fat grafting: A safe and effective treatment of craniofacial depression

Aim Many techniques have been described to correct craniofacial depression defect to achieve satisfactory result but they involve complicated reconstruction and considerable donor site morbidities. The result of fat grafting in correction of the defects is demonstrated in this study. Methods Six patients were treated during the period of November 2005 to August 2009. Median age was 47 years old. Diagnosis included post craniectomy forehead depression, lupus folliculitis, lymphoma panniculitis and Parry Romberg disease. Fat graft was harvested from abdomen, processed and then injected percutaneously to correct the defects. Total 13 procedures were performed, 9 under local anaesthesia, 3 under general anaesthesia and 1 under intravenous sedation. Standard facial photographs were taken before and at 4 months after the last treatment for comparison. The patients and 2 independent surgeons then score their level of satisfaction by using a score system from 0 to 10. Results The median hospital stay and operation time are 1 day and 67.5 minutes respectively. The treatment session ranges from 1 to 6 with median of 1 session. Median volume of fat graft injected is 15.5cc. The patients and the two plastic surgeons rank moderate to high level of satisfaction. The median satisfaction scores are 8.0, 8.5 and 8.5 out of 10 in these groups accordingly. Injection site haematoma and transient facial nerve palsy happened in one patient each. The morbidities resolved spontaneously. Conclusion Fat grafting is demonstrated to be safe and effective to correct craniofacial depression with high level of satisfaction and minimal morbidities.