The authors present their experience in three patients with the effect of early fat grafting at ≥6 months of age with later bone reconstruction of the orbitozygomatic area in patients with Treacher Collins syndrome. Fat grafting was performed two to three times after the age of six months. Fat was harvested from the abdomen or flank and prepared using a centrifuge. Malar bone reconstructions, using calvarial bone grafts, were performed in all patients ≥6 months after the last fat grafting session. There was no need for further reconstruction of the lower eyelids in two patients. Eighteen months after bone reconstruction, there was limited absorption of the bone grafts. Early fat grafting of the orbito-zygomatic area seems to improve contour, and restore volume. It may minimise bone resorption following zygomatic bone framework reconstruction. Fat grafting can be repeated and does not interfere with bone growth. This paper contributes to the literature on reconstruction of the lower eyelid and cheeks in Treacher Collins syndrome, with an elegant technique.

Early fat grafting for augmentation of orbitozygomatic region in treacher collins syndrome.
Konofaos P, Arnaud E.

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Aina Greig

St Thomas' Hospital, London, UK

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