Correction of Deep Nasolabial Fold using Dermofat Graft of Rhytidectomy Skin

ABSTRACT

One of the techniques for improvement of the nasolabial fold is the insertion of a fat or dermis fat graft. Guyuron introduced the dermis fat graft from the suprapubic area or the groin region. We innovated a procedure of rhytidectomy and dermis fat graft from rhytidectomy skin to the nasolabial fold area. In casse of a 48-year-old man a conventional cervicofacial flap was elevated from the preauricular and cervico-postauricular regeon to the nasolabial fold. The excess excised skin from the preauricular area was deepithehialized, contoured, and grafted to the nasolabial fold. Three pull-out suture were placed at the medial margin of the dermis fat graft to secure its position. This procedure have several advantages. First, a dermis fat graft under the nasolabial crease not only thickens the soft tissue but also provides a shield to prevent reattachment of the fibrous band to the dermis, which are causative of a recurrent crease. Second, it has no donor site morbidity. Third, the subcutaneous tissue of the preauricular area has much fascial component which survives better than fat injection of strip fat graft. Last, under the direct vision surgeon could place the graft in position he wants. This technique could be used in Asian whose skin is thick and whose maxilla is protruded.