Rehabilitation of irradiated head and neck tissues by autologous fat transplantation

Abstract

Background: Treatment of head and neck cancers allows good carcinologic results but induces aesthetic and functional sequelae. Autologous fat transplants have been used to correct aesthetic defects since the past century and exhibit many of the qualities of the ideal filler. Results reported here stem from experiences from 2000, with abdominal fat grafting in 11 patients who were referred to the authors' center for aesthetic subcutaneous or submucous head and neck reconstruction after radiotherapy.

Methods: Abdominal fat tissues were harvested, and injection into host sites was performed in a manner similar to that of the lipostructure technique described by Coleman. The postoperative follow-up periods ranged from 2 to 88 months (mean, 39.9 months). Clinical monitoring of the patients was carried out. Additional pathologic study was performed on irradiated tissues surrounding the scar and on abdominal fat and treated tissues.

Results: No surgical procedure complications occurred. For all cases, except for one patient, the rehabilitation was aesthetic and functional. The quality of life of the patients was improved. The pathologic data highlighted a decrease in irradiated morphologic patterns characterized by an absence of necrotic areas and a high vascular network density associated with a normal histologic structure.

Conclusions: Fat tissues can be successfully transplanted into irradiated areas, inducing both aesthetic and functional improvement. The cellular and/or tissular mechanisms underlying these changes need further investigation.