Appendectomy scar graft for lip augmentation
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Appendectomy scar graft for lip augmentation Fabrizio Schonauer 1
&
Tatiana Zaporojan 1 & Francesco D’Andrea 1
Received: 16 July 2020 / Accepted: 1 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
The mouth represents an important aesthetic unit of the face. Symmetrical, soft, and full lips are perceived as very attractive, so public demand for soft tissue lip augmentation is constantly increasing [1]. Various authors have published different solutions in search of a permanent filler material for lip augmentation [2]. The use of scar fibrous tissue as an autologous filler graft has been suggested together with scar revision [3]. We have used appendectomy scar tissue for lip augmentation in two female patients and want to share our results. Patients were operated under local anesthetic; the youngest aged 27 years, the oldest 55 years. The causes of defects were a whistle deformity of the upper lip, consequent to previously surgically corrected congenital bilateral cleft lip in the first patient (Fig. 1) and agerelated lip atrophy in the second patient. Photographs were taken pre-operatively. The appendectomy scar was marked in the upright position. The scar area was de-epithelialized; scar dermis graft was harvested and the donor site was closed primarily. At the upper lip, bilateral incisions were made 3 mm medial to the angle of the mouth on the inner mucosal surface. Stevens’ tenotomy scissor dissection was performed with the creation of a submucosal pocket along the length of the vermilion. Scar graft was tailored to suit the upper lip Presentation at meetings The paper was presented at the Italian Society of Plastic, Reconstructive and Aesthetic Meeting (SICPRE) in Palermo, Italy, 26–28 September 2019. * Fabrizio Schonauer [email protected] 1
Unit of Plastic Surgery, University Federico II, Via Sergio Pansini 5, Naples, Italy
length (Fig. 2); a tunnel was created anteriorly between the vermilion submucosal tissue and the orbicularis muscle. Scar graft was positioned into the lip pocket pulling the graft from side to side with a 3/0 polyester suture. Incisions were closed with absorbable 5/0 polyglactin sutures. Patients were observed at one month postoperatively and at one year. (Fig. 3) There were no perioperative complications such as bleeding, infection, or wound dehiscence. Follow-up included assessment of position, closure, lip sensation, aesthetic results, and donor-site morbidity. No residual retraction of lip borders and no alteration of lip sensation was observed. Patients did not require surgical revision for scarring or tissue protrusion. The donor-site scar healed well and was inconspicuous in both cases. There were no substantial volume changes at the lips over time. Aesthetic results in both patients were considered satisfactory. Patients did not report discomfort during speaking, eating, or during any facial expression. Results’ pictures were evaluated referring to the Lip Fullness Scale (LFS) [4]. This 5-point scale (minimal, mild, moderate,
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