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Correction of Lower Face Asymmetry using Dermofat Graft  

Lee, Joo Hong (Institute for Human Tissue Restoration, Department of Plastic & Reconstructive Surgery, Yonsei University College of Medicine)
Lew, Dae Hyun (Institute for Human Tissue Restoration, Department of Plastic & Reconstructive Surgery, Yonsei University College of Medicine)
Tark, Kwan Chul (Institute for Human Tissue Restoration, Department of Plastic & Reconstructive Surgery, Yonsei University College of Medicine)
Publication Information
Archives of Plastic Surgery / v.36, no.4, 2009 , pp. 475-480 More about this Journal
Abstract
Purpose: To correct the facial asymmetry and to achieve symmetry and balance, not only the soft tissue restoration of deficits but also creation and facial contour line such as mandible border and angle is important. Micro fat graft has limitation such as high resorption rate and somewhat limited ability to emphasize the rigid bony characteristics of the mandible angle due to its innate soft consistency. We have investigated the advantages of dermal fat graft over micro fat graft to correct asymmetry of the lower face in patients who had undergone mandibular reconstruction or distraction, using comparative analysis. Methods: Total of 12 patients were enrolled in our study: 6 micro fat graft and 6 dermal fat graft. Postoperative results were compared and analyzed at immediate postoperative period and more than 1 year later in each group with photographs, and analysised with image J program. Result: No complications were noted both in the micro fat type and the dermal fat type of procedures such as fat necrosis or micro calcifications. All of the patients who received micro fat graft, however had considerable amount of fat resorption after the procedure which led to two additional fat graft procedures. Although minor contour obliteration due to contracture was seen in patients who had undergone dermal fat graft procedure, no definite resorption was found even after more than one year follow-up. Results of dermal fat graft patients were satisfactory in terms of mandible angle symmetry. Secondary revision was necessary in one case due to overcorrection using dermal fat graft. Conclusion: The dermal fat graft has many advantages over the conventionally more popular micro fat graft to correct asymmetry of the lower face following mandible reconstruction owing to its lower resoption rate, more effective in emphasizing the natural curvilinear anatomical contours of the mandible angle and body and lower complication rates such as fat necrosis or micro calcifications.
Keywords
Dermis; Fat; Facial asymmetry;
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1 Moscona R, Ullman Y, Har-Shai Y, Hirshowitz B: Free-fat injections for the correction of hemifacial atrophy. Plast Reconstr Surg 84: 501 discussion 508, 1989   DOI   PUBMED   ScienceOn
2 Jurkiewicz MJ, Nahai F: The use of free revascularized grafts in the amelioration of hemifacial atrophy. Plast Reconstr Surg 76: 44. 1985   DOI   PUBMED   ScienceOn
3 Coleman SR: Structural fat grafting: more than a permanent filler. Plast Reconstr Surg 118: 108S, 2006   DOI   PUBMED   ScienceOn
4 Drommer RB, Mende U: Free fat transplantation in the face. J Craniomaxillafac Surg 23: 228, 1995   DOI   ScienceOn
5 Chajchir A, Benzaquen I: Fat-grafting injection for soft- tissue augmentation. Plast Reconstr Surg 84: 921; discussion 935, 1989   DOI   PUBMED   ScienceOn
6 Illouz YG: Present results of fat injection. Aesthetic Plast Surg 12: 175, 1988   DOI   PUBMED   ScienceOn
7 Kempf KK, Seyfer AE: Facial defect augmentation with a dermal-fat graft. Oral Surg Oral Med Oral Pathol 59: 340, 1985   DOI   ScienceOn
8 Wells JH, Edgerton MT: Correction of severe hemifacial atrophy with a free dermis-flap from the lower abdomen. Plast Reconstr Surg 59: 223, 1977   PUBMED   ScienceOn
9 Longaker MT, Siebert JW: Microvascular free-flap correction of severe hemifacial atrophy. Plast Reconstr Surg 96: 800, 1995   DOI   PUBMED   ScienceOn
10 Reich J: The application of dermis grafts in deformities of the nose. Plast Reconstr Surg 71: 772, 1983   DOI   PUBMED   ScienceOn
11 Achauer BM: A serious complication following medical grade silicone injection of the face. Plast Reconstr Surg 71: 251, 1983   DOI   PUBMED   ScienceOn
12 Billings E Jr, May JW Jr: Historical review and present status of free fat graft autotansplantation in plastic and reconstructive surgery. Plast Reconstr Surg 83: 368, 1989   DOI   PUBMED   ScienceOn
13 Chiu DTW, Edgerton BW: Repair and grafting of dermis, fat and fascia. In J.G. McCarthy (Ed.), Reconstructive Plastic Surgery, Vol.1, 3rd Ed. Philadelphia: Saunders, 1996
14 Terenzi V, Leonardi A, Covelli E, Buonaccorsi S, Indrizzi E, Fenicia V, Perdicchi A, Fini G: Parry-Romberg syndrome. Plast Reconstr Surg 116: 97e, 2005   DOI   ScienceOn
15 Niechajev I, Sevcuk O: Long-term results of fat transplantation: clinical and histologic studies. Plast Reconstr Surg 94: 496, 1994   DOI   PUBMED   ScienceOn