**7. Clinical implications**

In our institute, the Netherlands Cancer Institute, lipofilling is considered as a safe procedure. Therefore, this procedure is embedded as standard care for specific swallowing therapy to refractory patients. When a patient visits the hospital with swallowing complaints, the first step is to start swallowing rehabilitation under the guidance of a specialized speech and language pathologist. If the swallowing exercises do not give a satisfactory result, lipofilling can be considered. Patients are eligible if they have severe dysphagia caused by volume loss or muscle atrophy of the tongue or pharyngeal musculature due to HNC treatment. Patients may be eligible if they have no history of major oral surgery.

In the past 5 years, 20 patients have been treated with lipofilling injections at our institute. The procedure is preferably performed in collaboration with the plastic surgeon and under complete anesthesia. We prefer general anesthesia because, in

*Lipofilling in Post-Treatment Oral Dysfunction in Head and Neck Cancer Patients DOI: http://dx.doi.org/10.5772/intechopen.101824*

our experience, especially injecting the fat into the tongue felt uncomfortable. General anesthesia makes the injection less stressful for the patient. In general, we inject 10–15 cc of fat, and on average, two to three sessions are needed. No severe complications have been developed since we started performing this procedure.
