An Assessment of Autologous Fat Graft Administration in Hemifacial Microsomia Patients with or Without Distraction Osteogenesis: A Preliminary Study

Introduction: Hemifacial microsomia (HFM) is managed based on its classification, with treatment approaches according to severity. This study aims to assess the impact of autologous fat graft (AFG) administration in HFM patients with or without distraction osteogenesis (MDO). Methodology: The patients were sex and age-matched (mean age 5.8 ± 2.8 years) into two treatment groups: AFG-treated and MDO + AFG-treated and an untreated control group (mean age 5.8 ± 2.8 years), each with five patients. Computed tomography scans were used to measure the ramus height (MRH), ramus width (MRW), body length (MBL), body height (MBH), chin point deviation (CPD), and occlusal plane angle (OPA) across the three groups. Results: In the AFG-treated group, fat treatment resulted in significant increases in MRH ( P = 0.04) and MRW ( P = 0.01), along with significant decreases in CPD ( P = 0.02) and OPA ( P = 0.03), whereas the control group did not increase significantly. Similarly, in the MDO + AFG-treated group, fat treatment led to a significant increase in MBL ( P = 0.02) and a significant decrease in OPA ( P = 0.03), with no significant increase observed in the control group. The mean growth of AFG-treated MRH, MRW, and MBL increased, although not significantly, compared to the untreated group. In addition, the mean growth of MDO + AFG-treated MRH, MRW, MBL, and MBH did not increase significantly compared to the untreated group. Conclusion: AFG alone corrects major skeletal and soft tissue HFM deformities. It also supplements MDO, correcting residual MBL asymmetry and informing a new, function-based treatment algorithm. AFG is a valuable procedure in managing mild and severe HFM.