Outcomes following autologous fat grafting in head and neck oncologic reconstruction

Purpose
There is a paucity of clinical data that addresses the safety of autologous fat grafting in oncologic head and neck reconstruction. The aim of this study was to investigate the oncologic outcomes of autologous fat grafting in cancer patients undergoing head and neck reconstruction at a single institution.

Methods
We retrospectively reviewed 119 consecutive patients undergoing autologous fat grafting for oncologic head and neck reconstruction from January 2005 to July 2014. Three patients undergoing treatment for non-cancer diagnoses were excluded. Patient demographics, radiation history, operative factors, postoperative course, and oncologic assessments were analyzed. The primary outcome was oncologic recurrence and the secondary outcome was complication rate. 

Results
A total of 190 fat grafting procedures were performed in 116 eligible patients. Of these, 69% had received preoperative radiation (mean time to the first fat grafting procedure was 40.5 months, range 1 month to 20 years) and 66% had prior free flap reconstruction for their cancer surgery. The mean follow-up time from the first fat grafting procedure was 24 ± 22.3 months. The mean number of treatments was 1.6 ± 1 (range 1 to 6) with a mean injection volume of 24.8 ± 20.2 cc. The overall complication rate was 4%. Oncologic recurrence was observed in 6 patients (5.2%, 1 local, 3 regional, and 2 metastasis). The local recurrence was at a site separate and not continuous with the injected site.

Conclusions
This series suggests that autologous fat grafting in the head and neck region does not compromise tumor remission or surveillance and has a relatively low complication rate. Future prospective studies are needed to determine long-term oncologic safety.