Restoring form and function: The role of free dermal fat graft (FDFG) in post-parotidectomy reconstruction. A systematic review and meta-analysis of expected outcomes and patient satisfaction.

Purpose: This study aims to assess the outcomes of free dermal fat graft (FDFG) reconstruction following parotidectomy, evaluating both clinical complications and patient satisfaction with the procedure.

Methods: We conducted a systematic review and meta-analysis according to PRISMA guidelines, searching MEDLINE (via PubMed), Scopus, and the Cochrane Library for studies reporting on FDFG outcomes post-parotidectomy. Eligible studies included single-arm studies with data on recipient and donor site complications as well as patient satisfaction. Pooled complication rates were analyzed using a random-effects model to account for study heterogeneity.

Results: A total of 20 studies, representing 922 reconstructions in 919 patients, were included in the analysis. The overall rates of recipient site complications were low, with hematoma observed in 1.31% (95% CI: 0.50-3.34) and infection in 1.84% (95% CI: 0.95-3.53) of cases. The incidence of Frey's syndrome was 1.95% (95% CI: 0.74-5.02), and fat necrosis was noted in 1.74% (95% CI: 0.57-5.23) of patients. Donor site complications were minimal, with hematoma, infection, and seroma rates each below 1%. While there was high variability in satisfaction measures, results indicated favorable patient satisfaction with FDFG outcomes.

Conclusion: FDFG reconstruction following parotidectomy is a safe and effective method for correcting contour deformities, showing minimal complications and high patient satisfaction. The low incidence of complications, including Frey's syndrome, underscores FDFG as a viable option for facial contour restoration in parotid surgery, providing favorable aesthetic and functional outcomes.