Innovative Application of Dermofat Graft in Secondary Surgical Treatment of Cleft Lip: A Clinical Case Report
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Abstract
Background: Cleft lip and palate (CL/P) is a common congenital craniofacial anomaly that requires gradual management from infancy. Although primary measures such as labioplasty and palatoplasty can resolve the initial defect, secondary deformities such as lip coloboma, short columella, and disproportionate nasal contour often remain. Autologous dermofat graft is now an alternative to soft tissue augmentation with promising results.Case: An 8-year-old boy with a history of bilateral CL/P who had undergone labioplasty (2017), palatoplasty (2018), and alveolar bone graft (2023-2024), presented with complaints of asymmetrical lip and nasal shape. Examination revealed bilateral lip coloboma, nasal dorsum defect, and thickened postoperative scars. The patient was in good systemic condition and fit for surgery.Methods: Secondary correction procedures of re-labioplasty, Mulliken technique primary rhinoplasty, columella lengthening, and dermofat graft augmentation from the right gluteal fold were performed. The graft was fixed to the nasal dorsum and lip, with a reverse-U incision design and layered suturing. The patient received structured postoperative care and family education.Discussion: The use of dermofat graft has been shown to be safe and effective in improving soft tissue volume in CL/P patients. The literature supports the effectiveness of this technique in improving lip and nasal contours, with minimal complications. This approach is also relevant for regional hospitals with limited resources.Conclusion: The application of dermofat graft as part of secondary correction of CL/P shows satisfactory aesthetic results, without major complications, and can be a viable alternative in soft tissue-based craniofacial reconstructive surgery.
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