Ripristino del volume dei tessuti molli dopo radioterapia nel distretto testa-collo: confronto clinico tra lipofilling e filler iniettabili

Background Soft tissue atrophy and fibrosis are common sequelae following radiotherapy for head and neck cancer, significantly impacting patients’ function and appearance. Autologous fat grafting (lipofilling) and injectable fillers are both employed to restore volume, but each presents unique advantages and limitations. Despite growing clinical use, there is limited high-quality evidence on their safety and efficacy, particularly regarding oncologic risk and long-term outcomes. Materials and Methods A clinical and literature-based comparison was performed focusing on procedural requirements, regenerative potential, oncologic safety, and patient suitability. Discussion Lipofilling provides significant regenerative benefits due to the presence of adipose-derived stem cells, which may improve tissue quality and mitigate radiation-induced fibrosis. However, the procedure typically requires multiple sessions, operating room availability, and carries theoretical oncologic concerns, as definitive evidence excluding tumorigenic risk remains limited. Injectable fillers offer a minimally invasive, fast, outpatient solution with immediate volumetric restoration, ideal for patients unfit for surgery or requiring rapid correction. Nevertheless, few studies have evaluated their use specifically in irradiated head and neck tissues, and their regenerative capacity is comparatively limited. Conclusion Both lipofilling and injectable fillers have distinct roles in the post-radiotherapy rehabilitation of head and neck cancer patients. Lipofilling’s regenerative potential makes it particularly valuable for managing extensive fibrosis, whereas fillers provide a convenient, low-risk alternative for functional and aesthetic correction. Further research is needed to clarify long-term safety and optimize treatment algorithms tailored to individual patient needs.