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ISSN 2992-8559 (Electronic)
ISSN 1405-0625 (Print)

2023, Number 3

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Cir Plast 2023; 33 (3)

Facial sequential lipotransfer as part of the surgical treatment of Tessier 3 fissure

Vallarta-Rodríguez RA, Vallarta-Compeán S, Vélez-Benítez E, Euán-Vázquez C, Gutiérrez-Álvarez M, Viera-Núñez M, Trejo-Cervantes D, Morales-de CR

Language: Spanish
References: 18
Page: 113-119
PDF size: 336.55 Kb.


ABSTRACT

Facial clefts or fissures are a rare pathology, whose exact incidence is unknown. There are several classifications, the most used is the one proposed by Paul Tessier; being number 3 or oro-naso-orbital cleft with direct communication between the 3 cavities, the most common and most difficult to manage, with a wide presentation and severity; typically extending from the philtrum of the upper lip and lateral part of the nasal ala to the inner canthus of the eye on the affected side. They can be minor skin defects to those encompassing facial bony structures, bony deformity, and soft tissues simultaneously. They can be displayed partially, completely, bilaterally, or unilaterally. Reconstruction methods employ a range of procedures, mobilization and transposition of composite flaps, use of osteotomies and bone grafting in more complex cases. Since the 90's, lipotransfer has been used as an auxiliary method to provide volume, shape, consistency and tissue regeneration capacity in facial reconstruction processes and fissures have been an important part of it. We present a case of a patient treated for 8 years, 5 surgical procedures were performed, including sequential fat grafting in the last three; demonstrating the usefulness of the benefit of lipoinjection in facial reconstruction.


REFERENCES

  1. Omodan A, Pillay P, Lazarus L, Madaree A, Satyapal K. Scoping review of the morphology and anthropometry of Tessier craniofacial clefts numbers 3 and 4. Syst Rev 2019; 8 (1): 42.

  2. Kim EN, Moss WD, Yamashiro DK, Tuncer FB, Siddiqi FA. Management of Tessier type 3 cleft with a novel reverse palatal expander. J Craniofac Surg 2021; 32 (8): e814-e816.

  3. Kim GH, Baek RM, Kim BK. Soft tissue reconstruction in wide Tessier number 3 cleft using the straight-line advanced release technique. Arch Craniofac Surg 2019; 20 (4): 255-259.

  4. Da Silva Freitas R, Alonso N, Busato L y cols. Oral-nasal-ocular cleft: the greatest challenge among the rare clefts. J Craniofac Surg 2010; 21 (2): 390-395.

  5. Allam KA, Lim AA, Elsherbiny A, Kawamoto HK. The Tessier number 3 cleft: a report of 10 cases and review of literature. J Plast Reconstr Aesthet Surg 2014; 67 (8): 1055-1062.

  6. Uyar I, Uyar SB?, Altuntas Z. Bilateral Tessier type 3 cleft-repairment in a single session. Facial Plast Surg 2018; 34 (3): 335-336.

  7. Oh JH, Park YW. Anatomical repair of a bilateral Tessier No. 3 cleft by midfacial advancement. Maxillofac Plast Reconstr Surg 2018; 40 (1): 9.

  8. Cortez-Ortega C, Garrocho-Rangel JA, Flores-Velázquez J y cols. Management of the Amniotic Band Syndrome with Cleft Palate: Literature Review and Report of a Case. Case Rep Dent 2017; 2017:7620416.

  9. Das D, Das G, Gayen S, Konar A. Median facial cleft in amniotic band syndrome. Middle East Afr J Ophthalmol 2011; 18 (2): 192-194.

  10. Tessier P. Anatomical classification facial, cranio-facial and latero-facial clefts. J Maxillofac Surg 1976; 4(2): 69-92.

  11. Winters R. Tessier clefts and hypertelorism. Facial Plast Surg Clin North Am 2016; 24 (4): 545-558.

  12. Chen PK, Chang FC, Chan FC, Chen YR, Noordhoff MS. Repair of Tessier no. 3 and no. 4 craniofacial clefts with facial unit and muscle repositioning by midface rotation advancement without Z-plasties. Plast Reconstr Surg 2012; 129 (6): 1337-1344.

  13. Denadai R, Raposo-Amaral CA, Raposo-Amaral CE. Fat grafting in managing craniofacial deformities. Plast Reconstr Surg 2019; 143 (5): 1447-1455.

  14. Abu-Ghname A, Perdanasari AT, Reece EM. Principles and applications of fat grafting in plastic surgery. Semin Plast Surg 2019; 33 (3): 147-154.

  15. Balaji SM. Two-stage corrections of rare facial Tessier's cleft-3, 4, 5, 6, 7. Ann Maxillofac Surg 2017; 7 (2): 287-290.

  16. Denadai R, Lo LJ. Current state of the art in fat grafting: paradigm shift in surgical techniques and refinements in cleft and craniofacial reconstruction. Curr Opin Otolaryngol Head Neck Surg 2020; 28 (4): 263-271.

  17. Guibert M, Franchi G, Ansari E y cols. Fat graft transfer in children's facial malformations: a prospective three-dimensional evaluation. J Plast Reconstr Aesthet Surg 2013; 66 (6): 799-804.

  18. Pellon MA. Características moleculares y microanatómicas de la grasa y su aplicación en el tratamiento de quemaduras agudas y secuelas. Cir Plast Iberolatinoam 2020; 46: 53-62.




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