Unexpected Outcomes: Late Fat Hypertrophy and Obstructive Sleep Apnea Following Fat Grafting to the Posterior Pharynx for Velopharyngeal Insufficiency.

This article focuses on the development of obstructive sleep apnea (OSA) due to hypertrophy of autologous fat grafts used for posterior pharyngeal wall augmentation in treating velopharyngeal insufficiency (VPI). It presents a case series of three patients who developed severe fat graft overgrowth and subsequent OSA several years after fat grafting, necessitating surgical removal of the engrafted fat. The study highlights that weight gain postoperatively may contribute to fat hypertrophy and airway obstruction, emphasizing the need for cautious patient selection, careful graft volume management, and long-term monitoring for OSA. While autologous fat grafting is considered a less invasive option for small velopharyngeal gaps, the risk of late complications such as OSA should be weighed against potential benefits, especially in patients prone to weight gain.