Background and objective.

The reconstruction of soft tissues is a frequent requirement in craniofacial surgery for diferent congenital and acquired causes. Due to the complexity of the alterations, there is no uniform treatment. However, the use of fat grafts is a useful tool; the recipient site deferral before its placement is a rare technique in clinical practice.

Our objective is to clinically and histologically evaluate the benefts of deferral of the recipient site before placement of the dermal fat graft in facial soft tissue reconstruction.

Methods.

Descriptive observational study between 2016 and 2019, at the Hospital Universitario del Valle de Cali, Colombia, including 10 patients with hemifacial atrophy, hemifacial microsomia, and cancer sequelae: frst surgical time for the placement of alloplastic material and a second surgical time for the dermal fat graft placement. Also, we took biopsies from the recipient site during each intervention.

Results.

The scarring, facial symmetry and satisfaction had an average score of 8.7 ± 1.5 (6-10), evaluated from 0 to 10. One of the patients (10%) felt unsatisfed after the procedure and required lipoinjection without complications.

Histopathological analysis revealed an increase in the number of capillaries per feld (14.6 ± 4.0 vs. 8 ± 2.4) (P <0.05), tortuosity of the capillaries (1.8 ± 0.4 vs. 0.1 ± 0.3) (P <0.05) and leukocyte infiltration (1.9 ± 0.3 vs. 0.5 ± 0.5) (P<0.05) in the second surgical time when compared to the frst.

Conclusions.

This surgical technique is a fast and efective procedure for facial soft tissue reconstruction. It favors the leukocyte infiltration, number of capillaries and tortuosity of the vessels, achieving less resorption, higher integration and graft survival.

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