Plastic Surgery Research Council
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PSRC 60th Annual Meeting
Program and Abstracts

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Virtual Surgical Planning: Topographic Mapping for Facial Autologous Fat Transfer
Jillian E. Schreiber, BA, Carrie S. Stern, MD, Evan S. Garfein, MD, Katie E. Weichman, MD, Oren M. Tepper, MD.
Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA.

PURPOSE:
Computer-based virtual surgical planning (VSP) is currently limited to reconstruction of the facial skeleton. With VSP data can be used to plan a number of procedures including craniofacial procedures, or complex reconstruction. With the availability of three-dimensional (3D) surface photography, soft tissue VSP may soon be a reality as well. One clinical setting that may benefit from the novel concept of VSP is autologous fat transfer (AFT). Here we describe the use of topography, the two-dimensional representation of a three-dimensional surface, to virtually plan autologous fat transfer to the face.
METHODS:
Patients requiring AFT had 3D pre-operative photographs captured (Canfield Vectra H1). Creation of mid-sagittal plane bisected the 3D model into two distinct hemifaces (Figure 1). The reference hemiface was reflected onto the side of the defect and a color map was generated outlining the volumetric difference between surfaces.
RESULTS:
The boundaries of the color map were set at 1mm intervals, such that every point along a single curve represent discrete projection values, and progressive circles represent a 1mm step-up in anterior-posterior projection. The resulting topographical map of the patient’s volume deficiency was printed on transparent fenestrated paper, and used as a stencil for pre-operative markings. (Figure 2) Intra-operative AFT was injected according to the region and relative amounts as topographically indicated. (Figure 3)
CONCLUSION:
Topographic maps are a simplified translation of the complex three-dimensional facial contour. They provide an easy-to-follow guide tailored to the patient’s unique volume needs. Computer analysis of 3D photographs allowed for generation of an objective surgical plan, an advancement from current judgment based methods.


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