Free dermal fat graft reconstruction of the head and neck: An alternate reconstructive option

Am J Otolaryngol. 2017 May-Jun;38(3):291-296. doi: 10.1016/j.amjoto.2017.01.026. Epub 2017 Jan 27.

Abstract

Objectives: Ablative procedures of the head and neck often result in significant facial and cervical irregularities and cosmetic asymmetry. The deformity resulting from ablative procedures of the head and neck is a significant source of cosmetic morbidity and postoperative dissatisfaction. Reconstruction of post-ablative defects in the head and neck can employ a broad range of techniques, ranging from primary closure to free tissue transfer. The free dermal fat graft (FDFG) is one such option and has been used to repair volume defects of varying sizes after common head and neck procedures such as parotidectomy. However, its use is largely undocumented in the literature. We seek to further illustrate the FDFG as an alternate method of reconstruction of head and neck defects.

Study design: Non-randomized retrospective analysis.

Methods: The medical records of all patients who underwent primary autologous abdominal FDFG reconstruction of head and neck defects by a single surgeon at Vanderbilt University Medical Center from January 1997 to August 2010 were reviewed. All patients were called in order to assess their post-operative cosmetic satisfaction.

Results: Sixty-two patients were analyzed. Only three patients were found to have post-operative complications directly related to the FDFG. No complications were found at the donor site. Based on a telephone survey, the majority of patients were satisfied post-operatively with their cosmetic outcomes in the primary site and donor site.

Conclusions: From our experience the FDFG is a cosmetically and functionally advantageous option for reconstruction of ablative procedures of the head and neck.

Keywords: Cosmesis; Dermal fat graft; Head and neck; Reconstruction.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Free Tissue Flaps*
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Plastic Surgery Procedures / methods*
  • Retrospective Studies
  • Skin Transplantation / methods*
  • Subcutaneous Fat / transplantation*
  • Time Factors
  • Treatment Outcome
  • Young Adult