颞部自体脂肪移植术后颊部肿物的治疗效果

Therapeutic efficacy of the buccal masses after temporal autologous fat grafting

目的:探讨颞部自体脂肪移植术后出现颊部肿物的原因,总结治疗方法。方法:2018年10月至2019年12月,广东省第二人民医院整形科收治颞部脂肪移植后出现颊部肿物女性患者10例,年龄25~40(33±8岁),统计脂肪注射史、术后发病时间、术中情况、术后病理及细菌培养结果、愈后情况。结果:8例患者单侧颞部注射脂肪15~30 ml,术后1~6个月发现颊部肿物,术中见肿物为脂肪样肿物,部分含有液体,肿物位于颊间隙;术后病理提示为纤维化脂肪组织内局部坏死;另2例未能提供注射量。10例细菌培养均为阴性,1例抗酸杆菌阳性。术后随访6~12个月,9例患者术后恢复正常,1例再次手术处理后恢复正常。结论:颞部过量移植的脂肪和液化坏死脂肪可下移至颊间隙形成颊部肿物。颊部肿物应早期手术干预,以达到早期康复和美观。

Objective To investigate the causes of buccal masses after temporal autologous fat grafting,and to summarize the therapeutic methods to avoid medical disputes.Methods Ten female patients(25-40 years;mean age,33.1±7.5 years)with buccal mass complication after temporal autologous fat grafting were retrospectively analyzed,and statistics was done on their fat injection history,postoperative buccal mass symptom onset time,intraoperative mass conditions,postoperative pathological and fluid bacterial culture results,and postoperative recovery.Results The unilateral temporal fat injection volume was 15-30 ml,and the buccal masses occurred 1-6 months after temporal autologous fat grafting.Lipoid masses were found in the buccal space during the operation,and some of them contained liquid.The postoperative pathological results indicated local necrosis in fibrotic adipose tissues.All the fluid bacteria cultures were negative,only one showed positive culture of acid-fast bacilli.6-12 months postoperative follow-up visit was performed,and 9 patients recovered and 1 patient recovered after re-operation.Conclusions The overfilled fat and liquefied necrotic fat after temporal fat grafting may move down to buccal space to form buccal masses,which should be treated by operation early to achieve a good prognosis.