Fat grafting for frontotemporal contour restoration after neurosurgery

Background. Currently, aesthetic assessment becomes important after head and neck surgeries. Anterolateral approaches are common in neurosurgery, and frontotemporal contour deformities with asymmetry are the most common aesthetic defects. In 68% of cases, such sequelae can lead to severe psycho-emotional disorders. Autologous fat grafting (lipofilling) is a minimally invasive method with low risk of complications and stable long-term results. It is widely used in plastic reconstructive surgery but not routine after neurosurgical interventions. Material and methods. We present 4 cases of autologous fat grafting in patients with frontotemporal deformities after previous craniotomies. A 5-point Likert scale was used for subjective assessment of aesthetic outcomes after lipofilling. Results. “Complete satisfaction” with results was achieved in three patients; one patient rated the result as “satisfactory”. No postoperative complications were registered. Mean volume of injected autologous fat tissue per a procedure was 23.5 ml. The second procedure of lipofilling was required for two patients to achieve satisfactory results. Conclusion. These cases demonstrate feasibility of autologous fat grafting in patients with frontotemporal deformities after previous craniotomies. This method can be used as one of the options for minimally invasive soft tissue augmentation in temporal region considering graft survival, acceptable aesthetic outcomes and low risk of complications. When planning treatment, it is necessary to account for natural resorption of autologous fat tissue that often necessitates multiple lipofilling procedures.