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

Autologous fat grafting for posterior pharyngeal wall augmentation has been described as a safe and effective treatment option for a subset of patients with mild to moderate velopharyngeal insufficiency (VPI). Reported complications including hyponasality and obstructive sleep apnea (OSA) are exceedingly rare. We describe the development of severe fat graft hypertrophy and subsequent OSA in a series of 3 patients several years after undergoing autologous fat grafting for VPI. All patients required revisional surgery for the removal of the engrafted fat. Although rare, OSA can result from hypertrophy of autologous fat grafted into the posterior pharyngeal wall for treatment of VPI.