Sialocele following excision of delayed-onset inflamed facial fat graft: A case report

Early human evidence such as case series or small samples is exploring possible benefits.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Rationale Autologous fat grafting is a widely used technique for facial contour restoration and is generally considered safe. Nevertheless, delayed inflammatory reactions may occur and, in rare instances, require surgical intervention. Excision of the inflamed graft in the midface region carries a potential risk of intraoperative injury to critical structures, including the facial nerve and parotid gland. Patient concerns 24-year-old woman presented with progressive swelling and tenderness of the left cheek 4 years after autologous facial fat grafting. Diagnosis Magnetic resonance imaging revealed mixed fat necrosis and fluid collection beneath the superficial musculoaponeurotic system (sub-SMAS) plane, with extension into the masseter muscle. Interventions As the symptoms did not improve with antibiotics and anti-inflammatory medications, surgical excision was performed. Histopathological examination revealed benign fibroadipose tissue with mild chronic inflammation and fat necrosis. Following partial excision of the inflamed graft, a postoperative sialocele developed, raising suspicion of parotid gland injury. Conservative management with anticholinergic agents and intraparotid botulinum toxin injection was initiated. Outcomes The sialocele resolved without the need for surgical repair. At the 6-month follow-up, no recurrence was observed. Lessons Delayed inflammation may dev

Evidence level

Early human evidence such as case series or small samples is exploring possible benefits.

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