Tratamento de sequela de trauma de terço médio da face: Cirurgia ortognática e aumento malar com enxerto de gordura pediculado

Abstract

Maxillofacial injuries during childhood can create severe deformities as they interfere with the displacement of skull and face bones during normal growth. Occlusal abnormalities and skeletal discrepancies can occur due to several factors, with trauma being one of them. Deficiencies of the middle third of the face can be mitigated through different types of treatments, and the rotation of the buccal fat pad represents a technique for this problem, being simple and fast, with a low risk of complications. This paper reports the case of a Le Fort I type jaw fracture treated incorrectly during childhood. The patient evolved with insufficient maxillary development, an important deficiency of the facial middle third, and underwent orthognathic surgery along with malar repositioning of the buccal fat pad to restore occlusal and facial harmony. The treatment occurred correctly, without complications, and with the restoration of masticatory and respiratory function, improvement of facial aesthetics, and consequently, the quality of life of the patient. Facial trauma during childhood can negatively influence craniofacial growth, especially if treated incorrectly. This can lead to important deficiencies in adulthood, requiring orthognathic surgery to correct facial and occlusal disharmony. The use of buccal fat pad as a pediculated graft to gain projection of the facial middle third is an important technique with expressive results, which should be considered to improve facial aesthetics.