Does The Orientation of the Dermal-Fat Graft Affect How Well It Works In Buccal Lipectomy Reversals?

Q: Dr. Eppley, In your case study titled “Plastic Surgery Case Study – Buccal Lipectomy Reversal with Dermal-Fat Grafts” you write “With the suture placement through the graft the dermis surface of the graft into the pocket on the opposite side of the incisional closure.” I have 2 questions about the Dermal Fat Grafts (DFG) orientation  inside the buccal space, as it is described in the above excerpt:

 1. Does the Dermis side of the DFG face the cheek/away from the mouth, or does the Dermis side face the tongue/towards the mouth?

2. Does the orientation effect the viability of the graft?

A: In answer to your dermal-fat graft questions:

1) The dermis side faces the incision or the tongue side.

2) In the deep buccal fat pad space the orientation of the graft does not affect its external visibility.

Dr. Barry Eppley

World-Renowned Plastic Surgeon