**2. Diagnosis/patient presentation**

The ideal patient for this procedure is one with a volume deficit due to soft tissue atrophy. Multiple pathologies have soft tissue hypoplasia as a common characteristic. Hemifacial microsomia is one of the most frequent abnormalities of the craniofacial complex [22]. Progressive hemifacial atrophy or Parry-Romberg syndrome is characterized by a progressive deformation and reduced soft tissue volume on one side of the face. It is also accompanied by trigeminal neuralgia, alopecia areata, and eye alterations. This condition can benefit from the transfer of stem cell-enriched fatty tissue [23, 24].

We have recently described an alternative for postoperative cranioplasty for craniosynostosis. A specific population of these patients develops asymmetries categorized as depressions, particularly in the frontoorbital and temporal region, which are camouflaged using volumetric lipoinjection of adipose stem cells. This maneuver provides a volumetric effect and improves the inherent characteristics of the skin. All this contributes to a more harmonious facial appearance [25].

Its use has also been described in mild volumetric deficits of the middle and lower facial third secondary to skeletal fractures [26], even a camouflage option in patients with mild orthognathic alterations, such as micrognathia and microgenia [27]. We have used this alternative technique for more than a decade in our Craniofacial Surgery Clinic. In general, we use volumetric adipose stem cells in a wide range of disorders of the craniofacial complex, such as syndromes with a common characteristic, soft tissue hypoplasia, asymmetries secondary to facial skeletal trauma sequelae, and asymmetries due to craniosynostosis sequelae. Logically, this technical variant is also widely used to complement facial rejuvenation procedures or as an isolated facial profiling procedure.

Craniofacial malformations have a certain degree of psychosocial involvement, and children, particularly at an early age, are vulnerable to comments, ridicule, and harassment related to their appearance. Therefore, we consider it essential to provide an esthetic balance that promotes better facial symmetry. This is highly relevant since children at this stage are in the full development of their image, identity, and personality; hence, we consider that it is a priority to favor an adequate environment that facilitates greater self-esteem and better psychosocial development and integration. In some instances, it has a positive result in school performance [28].
