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A Prospective Clinical Trial Assessing Autologous Fat Transfer for Reconstruction of Craniofacial Deformities
Debra Bourne, MD; Jaci Bliley, MS; Isaac James, MD; Gretchen L. Haas, PhD; Albert D. Donnenberg, PhD; Vera Donnenberg, PhD; Barton Branstetter MD; Ryan TM Mitchell, MD; Spencer Brown, PhD; Kacey Marra, PhD; Sydney Coleman, MD; J. Peter Rubin, MD
University of Pittsburgh Medical Center
2016-01-31
Presenter: Debra Bourne
Affidavit:
This abstract represents original work which Debra Bourne has contributed significantly to, specifically in data collection, interpretation, and manuscript writing.
Director Name: Joseph Losee
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
PURPOSE - Craniofacial deformities are traditionally treated with flap procedures, bone grafting, and/or alloplast. The aim of this clinical trial was to assess the efficacy of autologous fat transfer (AFT) in the correction of craniofacial deformities.
METHODS - This HRPO-approved prospective cohort study was funded by the Department of Defense. Twenty subjects with craniofacial deformities were enrolled and underwent fat grafting with average volume of 23.9±13.2mL. Volume retention was evaluated using CT scans 3 weeks, 3 and 9 months postoperatively. Graft fat was evaluated for stromal vascular fraction (SVF) cell populations by flow cytometry. Quality of life (QOL) assessments were performed. After completion of the 9 month study, five subjects underwent second AFT.
RESULTS - Volume retention stabilized at 3 months, and averaged 63±16% at 9 months. The retention at 3 months predicted 9 month volume (p=0.006). Higher SVF cell viability correlated with improved volume retention (p=0.008). Volume retention in the first procedure was predictive of the second operation (p=0.05). Satisfaction with both physical appearance (p=0.002) and social relationships (p=0.02) and social functioning quality of life (p=0.05) improved from baseline to 9 months. There were no serious adverse events.
CONCLUSIONS - Fat grafting craniofacial defects is effective and safe, with 63% volume retention at 9 months and graft stability at 3 months and improved satisfaction with physical appearance and social functioning QOL scores. Viability of SVF from graft fat impacts overall retention. Volume retention of initial AFT is predictive of retention in subsequent procedures.
