Facial contour reconstruction with temporoparietal prelaminated dermal-adipose flaps

Abstract

Aim: Compared with those for free-fat grafts, resorption rates for vascularized adipose tissue transfers are very low. We analysed benefits of transfer of dermal-adipose grafts after prelamination upon the temporal fascia in reconstruction of facial contour defects. Patients and methods: Among 8 patients operated on between 2005 and 2008, facial contour anomalies had resulted from trauma in 5, while the remaining 3 had abnormalities with a congenital, postinfectious, or iatrogenic aetiology. In the first-stage operation, a dermal-adipose graft was taken from the inguinal region and prelamination upon the superior surface of the temporal fascia. After 5.5 months, the prelaminated dermal-adipose-fascial flap was raised as an island flap, passed through a subcutaneous tunnel in the temporal region, and set into the defect site. Results: Satisfactory cosmetic results were achieved in all patients. Except for a temporary frontal nerve palsy in 1 patient, no early or late complications resulted from this procedure. Conclusion: Prelamination of dermal-adipose grafts upon the temporoparietal fascia is useful in reconstruction of soft tissue defects requiring volume augmentation. (C) 2009 European Association for Cranio-Maxillo-Facial Surgery