Autogenous Fat Graft Research Articles

Hybrid Augmentation Mastopexy with New Generation of Smooth Surface Implants: Combining the Benefits of Fat Grafting, Inferior Muscle Support, and an L-Shaped Scar.

Augmentation mastopexy (AM) is a challenging procedure. Complications include implant displacement and visibility, which can be addressed, but the stability of the smooth implant surface and poor soft-tissue coverage may present limitations. This article describes a surgical technique for AM using a composite reverse inferior muscle sling associated with autogenous fat grafting. Forty-five patients (90 breasts; mean age, 37.7 ± 7.2 years) underwent hybrid composite reverse inferior muscular sling AM. An upper/medial pole area between the implant and the clavicle region and parasternal area was marked to receive fat grafting and divided into three zones. Three-dimensional imaging was used to evaluate lower pole stretch and intermammary distance. The average implant volume was 265 cc (range, 175 to 335 cc). The average fat volumes in zones I/II and III were 80.1 (range, 61.6 to 95.2 cc) and 39.3 (range, 25.2 to 47.3 cc), respectively. Five complications were observed in three patients (6.6%)-minor dehiscence in two (4.4%) and nipple-areola asymmetry in one (2.2%). The lower pole stretched 11.51% (9.9 mm) and 9.8% (8.5 mm) on the right and left sides, respectively ( P < 0.0001), between 10 days and 1 year postoperatively. The intermammary distance was reduced, on average, 49.9% (25.1 mm) ( P < 0.001) between the preoperative value and 1 year postoperatively. Hybrid composite reverse inferior muscular sling has led to improved aesthetic results for patients with breast ptosis and poor tissue coverage. Fat grafting and recognizing cleavage zones are still important to obtain satisfactory results. This procedure offers a good alternative for AM candidates, providing an adequate smooth surface for implant stabilization.

Role of Autogenous Fat Grafting in Sciatic Nerve Regeneration in Male Albino Rats

Role of Autogenous Fat Grafting in Sciatic Nerve Regeneration in Male Albino Rats

Volumetric Comparison Between CT Scans and Smartphone-Based Photogrammetry in Patients Undergoing Chin Augmentation With Autologous Fat Graft.

The most accurate methods for assessing fat grafted volume, such as computed tomography (CT) scan and magnetic resonance imaging, use 3-dimensional (3D) evaluation of the recipient area. Currently, other measurement techniques such as photogrammetry (compilation of photos) are employed. The aim of the present study was to compare 3D images obtained by CT scan with those obtained by photogrammetry in patients undergoing autogenous fat grafting to the chin. A prospective longitudinal study was undertaken to assess patients undergoing autologous fat grafting to the chin, capturing preoperative and postoperative (6 months) images with CT scan and photogrammetry. Captured images were submitted to 3D reconstruction with Blender image software. A total of 40 patients were submitted to surgery. Seventy-five percent were female. Median age and BMI were 26.5 years and 23.6 kg/m2, respectively. Median volume of fat grafted was 10 mL (interquartile range 8-12.25 mL). Results showed that the median preoperative volume measured by CT scan was larger than the photogrammetry measurement (12.48 mL vs 12.01 mL, respectively, P < .001). Likewise, a larger volume was measured by CT scan than by photogrammetry (15.54 mL vs 14.94 mL respectively, P < .001) 6 months postoperatively. However, there was no difference between CT scan and photogrammetry measurements of the change in volume from preoperatively to postoperatively (P = .89). There was no agreement between fat graft volume measurements obtained by 3D photogrammetry and CT scan techniques with regard to absolute values of fat graft volume measurements, however no difference was found between the 2 methods when comparing preoperative with postoperative fat graft volume variation.

Hybrid breast augmentation: our surgical approach and formula for preoperative assessment of fat graft volume.

Autogenous fat grafting (AFG) is a well-known procedure utilized in addition to breast augmentation (BA) to improve breast appearance. Plastic surgeons usually estimate the ideal AFG volume relying on their personal experience based on similar previous cases: inaccurate predictions could result in incorrect evaluation of donor sites and even needless fat transfer. The purpose of this paper is to describe and prove the validity of our surgical technique and provide a simple and easy-to-use mathematical formula to assess the adequate proportion, between the volume of the implants and of the AFG, in order to obtain a natural shape and a proper volume in BA. One hundred and twenty-two patients (244 breasts) were subjected to primary/secondary hybrid BA (HBA). A formula was utilized to assess the volume of fat graft. Data about their age, body mass index (BMI), incision and implants were collected. Follow-up for analysis was fixed at less than 15 days, 1, 3, 6 and 12 months for analysis. Preoperative photographs were compared with postoperative at 12 months. Pre and postoperative Breast-Q© were administered to every patient. A statistical analysis was performed comparing Breast-Q© preoperative means with postoperative ones through t-student test. We globally defined the patients as follows: "very dissatisfied" if total score 0-25; "somewhat dissatisfied", score 26-50; "somewhat satisfied", score 51-75; "very satisfied", score 76-100. All patients received Ergonomix-style Motiva Smooth/SilkSurface with low/high projection (range, 120-225 mL, mean 170 mL) and an average AFG volume of 600 mL (range, 480-720 mL). Breast-Q© analysis showed a statistically significant difference between preoperative and postoperative modules; 122 (100%) patients were "very satisfied". Thirteen cases of complications presented in 12 patients (10.65%): 5 hypertrophic scarring (4.09%), 3 wound dehiscence (2.46%), 3 hematomas (2.46%), 1 seroma (0.82%), 1 fat necrosis (0.82%). Our surgical technique proves low complication rate and short recovery times. Our mathematical formula to calculate the AFG seems to be both predictive and a precise guide for surgical decision-making in planning the treatment of patients candidated for HBA. In fact, the analysis of Breast-Q© questionnaires shows a high grade of satisfaction among patients. Further investigations should be performed in order to study a wider population and different type of implants.

Optimizing Surgical Outcomes with Small-Volume Silicone Implants Associated with Autogenous Fat Grafting in Primary and Revision Breast Augmentation Surgery: Soft Weight Hybrid (SWEH) Concept.

Simultaneous association of autologous fat grafting (AFG) with silicone implants, defined as a hybrid procedure, has been proposed for breast augmentation (BA). In some patients, larger-volume implants may result in larger incisions, with long-term effects including implant palpability, soft tissue atrophy, and secondary ptosis. Some patients do not want large volume implants, or have insufficient soft tissue coverage. Recent improvements in AFG have led to new surgical options in BA for addressing these cases. This study combines AFG in BA using small-volume implants, known as the SWEH (soft weight hybrid) approach, and evaluates aesthetic advantages and outcomes following primary/secondary BA. 25 patients (50 breasts) underwent SWEH procedures; this approach was indicated when the overlying tissue was insufficient to adequately cover the implant and patients refused large-volume implants. Three-dimensional images were obtained using a Divina 3D scanner system (AX3 Technologies, Miami, USA) to assess breast volume (BV) and intermammary distance (IMD) during follow-up. Mean patient age was 29.3 years (range: 21-42) and mean body mass index was 19.3 kg/m2 (15.3-27.2). The most common implant (SmoothSilk surface Round/Ergonomix style) volume was 180 cc (175-215), and patients received a mean volume of 125 cc of fat (89-168)/breast in the subcutaneous tissue. Preoperative average BV measurements were 236.85 cc (170-335). At 3 and 12 months post-procedure, the average BV values were 488.82 and 478.73cc, respectively (p=0.475). The average preoperative IMD was 31.76 mm (range, 22-43); at 3 and 12 months post-procedure, the average IMD was 20.47 and 20.94 mm, respectively (p=0.61). Postoperative complications included subcutaneous banding in the axilla (n = 1; 4%) and hypertrophic scarring (n = 1; 4%). Breast imaging exams were performed; in 2 breasts (8%) localized oil cysts were observed; no cases of suspicious calcifications, fat necrosis, or lumps were seen. Fat retention rate (1 year) was calculated by the difference between the BV expected with 100% fat intake and the real BV observed. In our sample we observed an average of 72.7 (range: 69.2-77.3, SD: 2.63) and 76.7 (range: 72.3-79.9, SD: 2.18) percent of fat intake on the right and the left breast respectively. No rippling, implant malposition, or infection was observed during a mean follow-up of 22 months (6-40). SWEH is a useful surgical alternative that combines the benefits of AFG and implant-based augmentation, particularly with regard to soft tissue coverage, and avoids the limitations of larger-volume implants. The association of small-volume gel implants and smaller scars can yield satisfactory aesthetic outcomes. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .

Materials Selection for the Injection into Vaginal Wall for Treatment of Vaginal Atrophy.

Vaginal atrophy caused by the aging process and perineal trauma has a negative impact on women. A new vaginal atrophy treatment is injection of materials into the vaginal wall, including platelet-rich plasma (PRP), autogenous fat graft (AFG), hyaluronic acid (HA), botulinum toxin (BTX), and collagen, but to date their efficacy has not been reviewed. Vaginal wall injection is available only for mild cases of vaginal atrophy or as an adjunct to vaginal surgery. PRP is used mainly to restore vaginal function, and multiple injections are needed to achieve good results in vaginal atrophy. HA, AFG, and collagen are used mainly to augment the vaginal wall. BTX injection can inhibit vaginal muscle spasm and reduce pain during sexual intercourse in patients with vaginismus. Injection of most of these materials into vaginal wall is effective and relatively safe. Vascular embolisms are the most serious complication of vaginal injection and should be prevented. In addition, there has been no randomized double-blind placebo-controlled trial or discussion of methods to avoid serious complications resulting from vaginal injection. Therefore, further studies of the injection of materials into the vaginal wall to treat vaginal atrophy are required, and the procedures should be standardized to benefit more patients.Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Endoscopic revision tympanoplasties: our experience

Abstract Objective: The aim of this study was to analyze the outcomes and complications of endoscopic tympanoplasties and review the strategies for endoscopic revision surgeries. Methods: Revision endoscopic surgeries are performed on patients with unsatisfactory outcomes after endoscopic tympanoplasties. This study was approved by the Ethics Committee of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China (approval No. 2020-0045-1). Results: Residual or recurrent tympanic membrane marginal perforation is treated by autogenous fat and cartilage grafting; graft collapse is treated using tissue from the tragus; and graft displacement is treated by endoscopic fixation of the cartilage–perichondrium complex. Lateral healing of the tympanic membrane, prosthesis fracture, prosthesis extrusion, middle ear adhesions, and recurrent perforation also required revision surgeries. Conclusion: Residual or recurrent tympanic membrane marginal perforation is the most common cause of unsatisfactory outcomes after endoscopic tympanoplasty; fat grafting is effective only for small perforations. Small cartilage grafts are an effective means of dealing with residual marginal perforation; the cartilage and perichondrium complex should be fixed securely. Patients with prosthesis implants require regular examination.

Hybrid Breast Augmentation: A Reliable Formula for Preoperative Assessment of Fat Graft Volume Based on Implant Volume and Projection.

Autogenous fat grafting (AFG) is an established technique used as an adjunct to breast augmentation (BA) to redesign breast shape. Surgeons often use experience and intuition to estimate AFG volume, which can result in incorrect assessment of donor areas and unnecessary fat removal. This aim of this study was to develop a method based on a mathematical formula, which utilizes implant volume and projection to predict AFG volume. Thirty patients (60 breasts) underwent primary hybrid BA. A software package (SketchUp) was used to simulate 3-dimensional AFG and implant volumes, which in turn were used to develop an equation for estimating AFG volume according to 3 different implant projections. The results for each group were compared, via Pearson's correlation coefficient, with the results of the clinical series. All patients received Motiva Ergonomix SmoothSilk/SilkSurface implants, ranging in volume from 175 to 355 cc (mean, 265 cc), as well as an average AFG volume of 79.2 cc/breast (range, 50-110 cc). Twenty-nine patients (96.6%) were either very satisfied or satisfied during a mean follow-up of 18 months (range, 6-28 months). A high correlation was observed between the AFG performed in the cohort and predictions obtained from the formula (r = 0.938, P < 0.001). The AFG volume in hybrid BA procedures can be estimated utilizing measurements based on implant volume/projection. This low-cost method can be applied to guide surgical decision-making in patients who are candidates for BA.

EFFECT OF PLATELET-RICH PLASMA, FAT PAD AND DURAL MATRIX IN PREVENTING EPIDURAL FIBROSIS

ABSTRACTObjective:Epidural fibrosis is one of the main reasons for requiring repeated surgical intervention. Our objective was to compare the effect of Platelet Rich Plasma (PRP) on the development of epidural fibrosis with collagen dural matrix and free autogenous fat graft.Methods:Male rats were separated into 3 groups. Laminectomy was implemented on the rats and epidural fat pad was placed in the first group (n = 7); equal size of collagen dural matrix was applied in the second group (n = 7); a single dose of PRP was applied in the third group (n = 7).Results:Epidural fibrosis was more common in the group that collagen dural matrix was applied when compared the ones that PRP was applied. PRP group presented better values in preventing epidural fibrosis when compared to the fat pad group, however this difference was not statistically significant.Conclusion:PRP is a material that can be easily obtained from the very blood of patients and at an extremely low cost; the main clinical relevance of our study is that the PRP might be an efficient material for better clinical results after laminectomy surgery due to its tissue healing and epidural fibroris preventing potentials. Level of Evidence V, Animal research.

Autogenous Fat Grafting to the Breast and Gluteal Regions: Safety Profile Including Risks and Complications

Given the widespread utility and therapeutic potential of autogenous fat grafting, plastic surgeons should be familiar with its safety profile and associated adverse events. This article provides a critical review of the literature and delineates risk factors associated with various complications when grafting to the breast and gluteal regions. The majority of adverse events are related to fat necrosis and require minimal diagnostic or therapeutic intervention. Larger graft volumes, as in cosmetic augmentation, are associated with higher incidences of fatty necrosis. The oncologic safety of fat grafting is supported by multiple clinical studies with thousands of breast cancer patients, albeit predominantly retrospective in nature. Although less frequent, serious complications include fat emboli during gluteal augmentation. Identification of associated risk factors and implementation of proper surgical techniques may minimize the occurrence of life-threatening complications.

Role of transport disc distraction osteogenesis for ramus condylar unit reconstruction and autogenous fat grafting in management of temporomandibular joint ankylosis

Role of transport disc distraction osteogenesis for ramus condylar unit reconstruction and autogenous fat grafting in management of temporomandibular joint ankylosis

Advances in treatment of facial rejuvenation in the past ten years

Facial aging is caused by several aspects involving skin, its deep soft tissue (fat, muscles, fascia ligaments, etc), and bones. The skin presents deepen wrinkles, darker, drying, and roughness. Volume loss and sag caused by gravity can be seen in deep soft tissue. And selective absorption can be seen in bones. At present, to combat facial aging caused by different causes, we have adopted comprehensive treatment methods such as facial rhytidectomy, embedded wire ascension, autogenous fat graft, hyaluronic acid or botulinum toxin injection, and optoelectronic techniques, etc.

Autogenous fat grafting for mild-to-moderate postoperative temporal hollowing after decompressive craniectomy: One-year follow-up.

BackgroundTemporal hollowing is inevitable after decompressive craniectomy. This complication affects self-perception and quality of life, and various techniques and materials have therefore been used to restore patients’ confidence. Autologous fat grafting in postoperative scar tissue has been considered challenging because of the hostile tissue environment. However, in this study, we demonstrate that autologous fat grafting can be a simple and safe treatment of choice, even for postoperative depressed temporal scar tissue.MethodsAutologous fat grafting was performed in 13 patients from 2011 to 2016. Fat was harvested according to Coleman’s strategy, using a tumescent technique. Patient-reported outcomes were collected preoperatively and at 1-month and 1-year follow-ups. Photographs were taken at each visit.ResultsThe thighs were the donor site in all cases for the first procedure. The median final volume of harvested fat was 29.4 mL (interquartile range [IQR], 24.0–32.8 mL). The median final volume of fat transferred into the temporal area was 4.9 mL on the right side (IQR, 2.5–7.1 mL) and 4.6 mL on the left side (IQR, 3.7–5.9 mL). There were no major complications. The patient-reported outcomes showed significantly improved self-perceptions at 1 month and at 1 year.ConclusionsDespite concerns about the survival of grafted fat in scar tissue, we advise autologous fat grafting for patients with temporal hollowing resulting from a previous craniectomy.

Qualitative analysis of the viability of autogenous fat grafts grafted in different environments of interstitial pressure. Preliminary results and description of a new experimental model in mini-pigs.

To evaluate the feasibility of an experimental model of autologous fat graft (AFG) in different interstitial pressure (IP) environments. Three mini-pigs(Minipig-BR) with age of 8 months (weight: 25-30 kg) were used. AFG were collected from the bucal fat pad, and grafted in the intramuscular pocket (biceps femoralis muscle). IP model was based on a fusiform ressection followed by primary closure "under tension". A blood pressure catheter located in the intramuscular region connected to a pressure module was applied to quantify IP. The mean operative time was 236 min (210 - 272 min). All the AFG and muscular segments were removed successfully. Average interstitial pressure CP and H were 3 and 10.6 mmHg respectively. The AFG were biopsied for histopathological analysis 30 days after graft. Hematoxylin-eosin staining and immunohistochemical analyzes (TNF-alpha, CD31 and Perilipine with monoclonal antibodies) were employed. The data show that minipigs model could be used as a recipient site for autologous fat graft techniques and allow the development of studies to explore the AFG intake and pathophysiology response.

Fat Graft and Bone Wax Interposition Provides Better Functional Outcomes and Lower Reossification Rates Than Extensor Digitorum Brevis After Calcaneonavicular Coalition Resection.

Calcaneonavicular coalitions are the most common form of tarsal coalitions. The prefered treatment for symptomatic coalitions is surgical resection; however, there are no published studies that directly compare different interposition techniques. The purpose of the present study was to retrospectively compare pain relief, functional outcomes, and complications of children and adolescents who had a resection of a symptomatic calcaneonavicular coalition with interposition of fat graft, bone wax, or extensor digitorum brevis (EDB). In total, 48 patients (56 ft) underwent calcaneonavicular coalition resection-interposition at 3 institutions from July 2008 to July 2015. There were 23 feet in group 1 (fat graft), 18 feet in group 2 (bone wax), and 15 feet in group 3 (EDB). Patient demographic characteristics were similar between all groups for age, sex, coalition type, and symptoms onset. Data concerning clinical and radiographic features, surgical technique, and postoperative complications were obtained from all available medical records. Radiographs were evaluated at last follow-up to determine coalition regrowth. Preoperative and postoperative pain was assessed with the visual analog scale, and function was assessed with use of the American-Orthopaedic-Foot and Ankle Society (AOFAS) score. Pain improved to an average of 0.5 in the first group (range, 0 to 6), 0 in group 2, and 1.7 in group 3 (range, 0 to 5) (P=0.033). The average AOFAS score improved from 59 (range, 33 to 71 points) to 98 points (range, 62 to 100 points) in the fat graft group, from 50 (range, 34 to 62 points) to 98 points (range, 88 to 100 points) in the bone wax group, and from 48 (range, 30 to 60 points) to 75 points (range, 70 to 95 points) in the EDB group (P<0.001). Eight feet had regrowth of the coalition on the postoperative radiographs: 1 in group 1 (4%), 1 in group 2 (6%), and 6 in group 3 (40%) (P=0.004). Five feet from the third group developed progressive symptoms. In our study, autogenous fat graft and bone wax interposition techniques provided better pain relief, gave better functional scores, and avoided more effectively coalition reossification than EDB technique. Further studies are required to evaluate safety of bone wax as an interposition material. Level III-therapeutic.

A Cluster Randomized Controlled Clinical Trial to Evaluate Fate and Volumetric Shrinkage of Interposed Pedicled Buccal Pad of Fat and Abdominal Fat in the Treatment of TMJ Ankylosis

The autogenous fat grafts and dermal fat grafts show good results as compared to others various interpositional material. Though fat interpositioning in TMJ ankylosis is an emerging practice, we had no knowledge what happens to the interposed fat, whether abdominal fat is better than buccal pad of fat or vice versa. Hence the study was done to evaluate the fate of interposed fat graft as a interpositional arthroplasty with the help of MRI.

Refined autogenous fat grafting as a de novo treatment of oral submucous fibrosis

Refined autogenous fat grafting as a de novo treatment of oral submucous fibrosis

TEMPOROMANDIBULAR JOINT DISC REPOSITIONING BY MODIFIED ANCHORAGE SURGERY

The appropriate position and morphologic preservation of the disc are critical to prevent excess remodeling and degenerative changes within the temporomandibular joint. The paper reviews the history of surgical approaches to disc displacement and presents a modified technique of temporomandibular joint disc reposition developed by the authors. Seven key points are highlighted that are essential for the success of the proposed arthroscopic intervention. The anterior release should be complete, with avoidance of any damage to the masseteric nerve and vessels. Expansion of the upper joint space to ensure appropriate placement of the incision should be performed with the straight ramus retractor used to distract the mandible and injecting saline, which helps prevent cutting of the disc or cartilage when entering the fossa. The disc should be repositioned without any tension. Two mattress sutures (one medial and one lateral) should be placed at the border of the disc and the posterior band. The disc is fixed with one bone anchor which is sufficient for its further stability. The position of the disc should be overcorrected to avoid relapse. Autogenous fat grafting in the anterior release region is vital to lessen scarring and thus to improve long term outcomes. All steps of the proposed technique are discussed with comparison with previous approaches. Factors influencing a relapse and measures to prevent it are reviewed in detail.

The effects of the centrifugation speed on the survival of autogenous fat grafts in a rat model

Purpose The most important problem in fat transplantation is the durability, which is closely associated with the applied technique. This study includes the comparison of different centrifugation speeds on the survival of autogenous fat grafts in rats.Materials and methods Forty-nine Sprague-Dawley rats were divided into seven groups and the left inguinal fat pad was extracted and re-implanted under the scalp after performing appropriate preparation processes. In the first group the fatty tissue was re-implanted in en-bloc fashion and in the second group it was re-implanted after trimming. After trimming, centrifugation with a G-force of 111.8 (1000 rpm) was performed in the third group, 447.2 (2000 rpm) in the fourth group, 1006.2 (3000 rpm) in the fifth group, 1788.8 (4000 rpm) in the sixth group, and 2795 (5000 rpm) in the seventh group for 4 minutes. The fat grafts were taken after 3 months and histopathological and statistical evaluations were performed.Results The rate of viable fat grafts was significantly higher in the 4th and 5th groups comparing to the first three groups. Total weight and volume amounts of the 4th and 5th groups were also significantly higher comparing to the first three groups.Conclusion Maximal long-term durability and fat cell viability results were obtained in the groups with 2000 rpm or 447.2 G-force/4 minutes and 3000 rpm or 1006.2 G-force/4 minutes centrifugation speed, indicating that 4 minutes centrifugation with an average G-force of 698.75 or 2500 rpm provides the best results for the survival of autogenous fat grafts.

Temporomandibular Joint Ankylosis Can Be Successfully Treated With TMJ Concepts Patient-Fitted Total Joint Prosthesis and Autogenous Fat Grafts

To measure and identify factors associated with treatment outcomes for patients with temporomandibular joint (TMJ) ankylosis treated with TMJ Concepts patient-fitted total joint prostheses and autogenous fat grafts. This retrospective cohort study evaluated records of patients with TMJ ankylosis from a single private practice, treated from 1992 to 2011, who met the following inclusion criteria: 1) radiographic evidence of bony ankylosis, 2) limited incisal opening, 3) minimum of 12months' follow-up, and 4) treatment with TMJ Concepts (Ventura, CA)/Techmedica (Camarillo, CA) total joint prostheses and fat grafts. For each patient, the number of previous TMJ surgical procedures, as well as the estimated age of ankylosis onset, age at surgery, and length of postoperative follow-up, was recorded. Subjective evaluations were made with Likert-like scales (from 0 to 10) for 1) TMJ pain, 2) headache and facial pain, 3) jaw function, 4) diet, and 5) disability. Objective evaluations included maximal incisal opening and excursion movements. Nonparametric statistics were used for analysis. There were 32 patients (22 female and 10 male patients) with 48 ankylosed TMJs (16 bilateral and 16 unilateral) in this study, with a mean age of 39years (range, 11 to 68years), 2 or more previous TMJ surgical procedures in 69%, and a mean follow-up period of 68months (range, 12 to 168months). Trauma was the major etiology of TMJ ankylosis, occurring in 17 of 32 patients (53%). The following improvements occurred: The median value for TMJ pain changed from 8.0 preoperatively to 1.5 at longest follow-up; headache, from 8 to 3.5; facial pain, from 8 to 4; jaw function, from 8 to 2.5; diet, from 7 to 3; and disability, from 7 to 1.5. The median incisal opening was 14.5mm (interquartile range, 6.3 to 20mm) preoperatively and 35mm (interquartile range, 30 to 40mm) at longest follow-up. The median left lateral excursion improved from 0.5 to 2mm, and the median right lateral excursion improved from 1 to 1.3mm. All of these improvements were highly significant (P < .001, Wilcoxon tests). Equally favorable outcomes were found in patients with 12 to 48months of maximal follow-up and patients with more than 48months of maximal follow-up. The treatment of TMJ ankylosis with the TMJ Concepts patient-fitted total joint prosthesis in combination with fat grafting around the articulation area of the prosthesis is a viable and predictable method for improving pain levels, function, and quality of life, as well as prevention of reankylosis of the TMJ.