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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.<\/jats:p>","DOI":"10.1177\/10556656241307422","type":"journal-article","created":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T06:06:51Z","timestamp":1734502011000},"page":"868-874","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Unexpected Outcomes: Late Fat Hypertrophy and Obstructive Sleep Apnea Following Fat Grafting to the Posterior Pharynx for Velopharyngeal Insufficiency"],"prefix":"10.1177","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7090-1822","authenticated-orcid":false,"given":"Hannes","family":"Prescher","sequence":"first","affiliation":[{"name":"University of Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shelby R.","family":"Svientek","sequence":"additional","affiliation":[{"name":"University of Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marissa Y.","family":"Habeshy","sequence":"additional","affiliation":[{"name":"University of Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven J.","family":"Kasten","sequence":"additional","affiliation":[{"name":"University of Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven R.","family":"Buchman","sequence":"additional","affiliation":[{"name":"University of Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2015-4213","authenticated-orcid":false,"given":"Christian J.","family":"Vercler","sequence":"additional","affiliation":[{"name":"University of Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,12,18]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000003335"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/1055665620913440"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2022.06.036"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000009822"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000010098"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cps.2013.12.010"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e3181c1fec6"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1597\/11-211"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000010443"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2023.10.107"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000008193"},{"issue":"7","key":"e_1_3_2_13_2","doi-asserted-by":"crossref","DOI":"10.1097\/SCS.0b013e31825b3ba9","article-title":"Obstructive sleep apnea after dynamic sphincter pharyngoplasty","volume":"23","author":"Ettinger RE","year":"2012","unstructured":"Ettinger RE, Oppenheimer AJ, Lau D, Hassan F, Newman MH, Buchman SR, Kasten SJ. 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