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Fat grafting while performing Microtia Surgery

Patients with Microtia can present with other facial deformities including cheek hypoplasia and asymmetry, jaw deformity or hypoplasia, orbital deformity and overall facial asymmetry. Sometimes, the reconstruction of the ear does not completely correct facial balance and the patient needs fat grafting. Fat grafting involves harvesting fat from the patient central abdominal are or inner thighs using an non-traumatic liposuction technique and injecting it in the cheek that is hypoplastic.

Liposuction is performed using a tiny stab incision in the inferior portion of the umbilicus to allow harvesting of fat. The collected fat is then processed and then loaded into 1 mL syringes.  Through the same existing ear incision that we use to do the ear reconstruction, fat is injected into the area of the malar hypoplasia for improved facial contour. When we inject fat, approximately 50-70% melts down and 50-30% remains, thus we always over correct to compensate for the loss of volume over time.

It is not uncommon that patients need a second round of fat grafting.

Often the parents ask how is the fat going to evolve with time. Most of the time, the fat will grow proportionally to the patient. If the patient gains weight, the fat on the cheek will grow proportionally to the other cheek. If the patient loses weight, he will lose the fat on his cheek proportionally. The risks of fat grafting are quite minimal.

There will be some bluish/purplish discoloration and bruising around the donor sites however, this gets better quickly and completely disappears after a couple of days. The recipient site may also have some mild bruising and discoloration, but it also gets better very quickly.

Performing fat grafting to the cheek at the same time of the ear reconstruction is easy and allows tackling 2 problems at once. This is a more holistic approach.

If you are interested into Microtia reconstruction using MEDPOR™ with or without fat grafting, feel free to contact Dr. Tahiri.

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