Correction of whistle deformity using autologous free fat grafting: first results of a pilot study and review of the literature

Oral Maxillofac Surg. 2017 Dec;21(4):409-418. doi: 10.1007/s10006-017-0648-8. Epub 2017 Sep 17.

Abstract

Purpose: Whistle deformities are frequent sequelae after surgical correction of cleft lip, trauma, or tumor excision. The aim of this study was to examine the role of autologous free fat grafting in the reconstruction of whistle deformity.

Patients: Fifteen patients with whistle deformity were enrolled in this pilot study. The mean follow-up period was 19 months. Liposuction was done followed by the replantation of an average of 2.2 ml autologous fat per patient (range 0.7-4 ml). An overcorrection was performed in all patients.

Results: All the patients showed improvements in whistle deformity. The mean resorption rate was 53% (range 30-80%). Three patients (20%) were not satisfied with the postoperative result. Six complications were assessed (4× feeling of pressure [27%], one hematoma [7%], one recurrent pain [7%]), but a major complication did not occur.

Review: We also present a review of the literature with different techniques that were described in the last 20 years.

Conclusion: Autologous free fat graftings for reconstruction of whistle deformity represent a reliable method with a low complication rate. However, the resorption rate is unpredictable. If necessary, several autologous fat transplantations should be conducted at an interval of at least 6 months.

Keywords: Autologous free fat grafting; Lip correction; Reconstruction; Vermilion notching; Whistle deformity.

Publication types

  • Review

MeSH terms

  • Adipose Tissue / transplantation*
  • Adolescent
  • Adult
  • Aged
  • Cleft Lip / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Lip / injuries*
  • Lip / surgery*
  • Lipectomy
  • Male
  • Patient Satisfaction
  • Pilot Projects
  • Plastic Surgery Procedures / methods*
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery*
  • Vestibuloplasty
  • Young Adult