Background: Injection of autologous fat grafts for facial soft-tissue augmentation is becoming increasingly popular for facial rejuvenation but has not been extensively applied to the correction of congenital and traumatic deformities.

Methods and Materials: Here, the authors report their experience with autologous fat injection to re-establish facial contour in pediatric and adult patients with a range of deformities of varying etiology. The technique involves harvesting of fat by syringe aspiration, followed by brief centrifugation and multiple pass, small volume injection. No washing, growth factor addition, carrier or intervening culture steps were used. The authors report their results with a minimum of 6-month follow-up in 10 patients with diverse conditions including hemifacial microsomia, Parry-Romberg disease, and post-traumatic deformities.

Results and Conclusion: Improvement in facial contour and symmetry occurred in all cases. Secondary injections are occasionally required to achieve optimal results. There were no serious complications. The effects of fat injection are lasting, implying long-term survival of the injected fat cells. Autologous fat injection is a useful option in the treatment of congenital and acquired facial deformities that, in select cases, offers advantages over other approaches including low morbidity, relative technical ease and the ability to “fine-tune”.