Correction of whistle deformity using autologous free fat grafting: first results of a pilot study and review of the literature.

PURPOSE: Whistle deformities are frequent sequelae after surgical correction of cleft lip, trauma, or tumor excision. The aim of this study was to examine the role of autologous free fat grafting in the reconstruction of whistle deformity. PATIENTS: Fifteen patients with whistle deformity were enrolled in this pilot study. The mean follow-up period was 19 months. Liposuction was done followed by the replantation of an average of 2.2 ml autologous fat per patient (range 0.7-4 ml). An overcorrection was performed in all patients. RESULTS: All the patients showed improvements in whistle deformity. The mean resorption rate was 53% (range 30-80%). Three patients (20%) were not satisfied with the postoperative result. Six complications were assessed (4× feeling of pressure [27%], one hematoma [7%], one recurrent pain [7%]), but a major complication did not occur. REVIEW: We also present a review of the literature with different techniques that were described in the last 20 years. CONCLUSION: Autologous free fat graftings for reconstruction of whistle deformity represent a reliable method with a low complication rate. However, the resorption rate is unpredictable. If necessary, several autologous fat transplantations should be conducted at an interval of at least 6 months.

Use of dermis-fat grafts in the prevention of Frey's syndrome after parotidectomy.

OBJECTIVE: To examine the role of dermis-fat grafts in preventing gustatory sweating and in the reconstruction of facial contour defects after parotidectomy. PATIENTS: Twenty-three patients with tumours of the parotid gland were enrolled in this prospective clinical study from January 2006 to February 2014. All of them were evaluated for wound complications, Frey's syndrome, satisfaction, and tumour relapse. Follow-up periods ranged from 6 to 72 months. RESULTS: Nineteen patients completed the study. Nine complications observed in six patients were assessed (two haematomas [10%], one seroma [5%], one sialocele [5%], and recurrent pain in five patients [26%]). None revealed Frey's syndrome. Satisfactory results were found in relation to scar, facial contour, and overall outcomes. CONCLUSION: Dermis-fat grafts appear to be an effective method of preventing Frey's syndrome after parotidectomy. The stable long-term results and high patient satisfaction lead to the application of this operation technique in daily routine.

Nasal Entrance Correction in Unilateral Cleft Lip Repair.

PURPOSE: Correction of cleft nose deformity in patients with unilateral cleft lip is challenging and involves primarily the nasal cartilage and the nasal entrance. No consensus on the most effective surgical technique has been reached. This article describes a surgical procedure for nasal entrance correction. PATIENTS AND METHODS: In this retrospective study, 30 adult patients underwent secondary nasal entrance corrections. According to a modified Van der Meulen technique, a nasal alar rim flap with anatomic repositioning of the alar cartilage was applied. Symmetry and esthetic results were evaluated by semiquantitative photographic analysis. RESULTS: In all patients, the nasal tip was narrowed considerably, and a lifting of the nasal tip was achieved. Columellar elongation averaged 40%, and the form of the nostril was changed from horizontally oval to longitudinally oval. CONCLUSION: The described technique is well suited for a sustainable correction of complex cleft-induced deformities without visible scars in adult patients.