The Current Status of the Autologous Fat Grafting for Pediatric Craniofacial Patients.

Since its first introduction, autologous fat grafting (AFG) has undergone multiple refinements and has become a common treatment option within plastic surgery. It is a safe, quick, economical, and minimally invasive method for volume augmentation and is finding its own indications in the pediatric craniofacial surgery patients. Because there is currently a paucity of literature regarding the use of AFG in the pediatric population compared with the adults, the authors performed a systematic review of the literature using PubMed, Cochrane Library databases, and the Journal of Plastic and Reconstructive Surgery using the terms of fat grafting/lipofilling, fat grafting, and craniofacial surgery to include articles that contained pediatric patients. While reviewing AFG in the pediatric craniofacial patients, indications, technique, and challenges were specifically evaluated and an algorithm of approach was proposed. In current practice, the choice of microvascular free flap versus AFG is one of the surgeon preferences on a case-by-case basis. With the low complication rate and ease of use, selection of AFG for the repair of soft tissue defects in pediatric craniofacial patients is increasing and may come to surpass use of traditional invasive methods such as free flaps. It should also be considered as a useful adjunct to other concurrent invasive procedures, that is, bony adjustments.