Craniomaxillofacial deformities/cosmetic surgery
Submental Fat Transfer: An Approach to Enhance Soft Tissue Conditions in Patients With Submental Lipomatosis After Orthognathic Surgery

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Soft tissue changes after orthognathic surgery and their effects on the esthetic appearance of the patient can be the most challenging and sometimes undesired parts of this procedure. Although the soft tissue profile is improved in many orthognathic surgeries, suboptimal soft tissue changes may necessitate some special interventions. To overcome these problems, the authors present a technique based on transferring the submental fat (in patients with submental lipomatosis) to the lips, paranasal areas, or other sites of the face instead of discarding it. According to this technique, in patients with submental lipomatosis, submental fat can be used not only to compensate some of the unpleasant soft tissue effects of orthognathic procedures (eg, thinning of the upper lip after mandibular setback), but also to improve pre-existing soft tissue problems, which may be worse after orthognathic surgeries (eg, a poor neck and chin profile). Although submental fat liposuction is a traditional technique to improve the neck and chin profile, the present technique is based on transferring the harvested fat to other sites of the face (lips, paranasal areas, etc) instead of discarding it.

Section snippets

Fat Harvesting

Preoperative marking is performed with the patient seated. Two small incisions are marked approximately 1 cm from the midline on each side, near the submental crease. The authors use 2 incisions for entrance of the aspiration cannula for better access to fat tissues lateral to the incision. Two small stab incisions are made in the submental area (Fig 1). Harvesting is performed using a specific aspiration cannula with a diameter of 3 mm, a length of 15 cm, and openings at the 2 sides. A 10-mL

Discussion

The main goals of successful orthognathic surgeries are the establishment of a functional and stable occlusion and enhanced facial esthetics. Soft tissue changes after orthognathic surgery remain one of the challenging issues among maxillofacial surgeons. Unpleasant soft tissue changes in some procedures and suboptimal improvements in some other procedures mandate some simultaneous or late soft tissue interventions.1, 2, 3 Submental lipomatosis can exist independently of generalized body fat.

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