Introduction: Facial infiltrating lipomatosis (FIL) is a rare and underreported clinical entity. Presence since birth and hemifacial swelling and asymmetry is always present along with dentoskeletal hypertrophy. Clinical management varies from conservative liposuction at an early age to aggressive subtotal resection in adulthood. Case presentation: A 21-year-old female patient, operated 3 times before for unilateral facial swelling presented with massive diffuse swelling on the right side of the face. Contrast CT showed infiltrating lipomatosis with the complete fatty replacement of ipsilateral parotid gland and masseter muscle. The case was managed in our unit by staged resection of swelling and minor cosmetic corrections. Conclusion: Management of facial infiltrating lipomatosis in adult patients can be done with staged resection of the lesion and cosmetic corrections for residual deformities but ideal outcome and prevention of recurrence is difficult.
Multiply fragmented fractures of the maxillofacial region are difficult to fix with traditional miniplate osteosynthesis because of the extremely small size of fragments, complex three-dimensional anatomy, thin bone unable to hold screws and multidirectional pull of muscles. We intend to present a technical note on a case series of extremely comminuted midfacial fractures reconstructed with stock Titanium mesh, cut to shape and used to mold the small fragmented segments into the shape of the facial bones. Severe fragmentation of midface leads to facial hollowing, tissue prolapse and asymmetry even after major facial buttresses are fixed and reconstructed. Simple stock Titanium mesh can be used to reconstruct these severe fragmentations of thin bones of the midface as shown in the series and avoid late and unsightly complications.
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