Facial contour reconstruction with temporoparietal prelaminated dermal–adipose flaps

Summary 

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.

Keywords: facial reconstruction, prelamination, temporoparietal fascia