Akdag Osman, Evin Nuh, Karamese Mehtap, Tosun Zekeriya
Konya, Turkey.
From the Department of Plastic Surgery, Selcuk University Medical Faculty.
Plast Reconstr Surg. 2018 Jan;141(1):148-151. doi: 10.1097/PRS.0000000000003956.
The scar that occurs after cleft lip surgery poses a serious cosmetic problem. One of the methods used to solve this problem in adult male patients is hair transplantation. However, satisfactory results with this method cannot always be achieved because of possible graft loss. The corrective feature of fat grafting has been reported in many studies. The authors' aim with this report is to share their results with hair transplantation combined with fat grafting in patients with cleft lip.
This study included 20 patients who had both a scar and alopecia in the cleft lip area. The patients underwent fat grafting from the periumbilical region by means of miniature liposuction harvesting cannulas. Three months after fat injection, hair transplantation was performed with hair from the submental area and scalp using the folliculate unit extraction technique. Patients were followed for 12 months. Survival rate of transplanted hair and patient satisfaction were analyzed after the procedures.
After this camouflaging technique with fat grafting and hair transplantation, the scar was hidden quite well. The graft survival rate was also better compared with results from similar studies. Patient and observer satisfaction results with the scar tissue were significantly improved, which was confirmed statistically.
This study demonstrates that this combined camouflaging technique is a very effective treatment in male patients with cleft lip who have serious secondary upper lip scars. The authors present a series of patients treated with this technique, which resulted in a high level of patient satisfaction.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
唇裂修复术后形成的瘢痕会造成严重的美容问题。在成年男性患者中，解决这一问题的方法之一是毛发移植。然而，由于可能出现移植物丢失，该方法并非总能取得满意效果。许多研究报道了脂肪移植的修复特性。作者撰写本报告的目的是分享唇裂患者毛发移植联合脂肪移植的治疗结果。
本研究纳入20例唇裂区域有瘢痕且伴有脱发的患者。采用微型吸脂采集套管从脐周区域采集脂肪进行脂肪移植。脂肪注射3个月后，采用毛囊单位提取技术，使用颏下区域和头皮的毛发进行毛发移植。对患者进行12个月的随访。术后分析移植毛发的存活率和患者满意度。
经过脂肪移植和毛发移植的这种掩饰技术后，瘢痕被很好地隐藏起来。与类似研究结果相比，移植物存活率也更高。患者和观察者对瘢痕组织的满意度结果有显著改善，这在统计学上得到了证实。
本研究表明，这种联合掩饰技术对于患有严重继发性上唇瘢痕的唇裂男性患者是一种非常有效的治疗方法。作者展示了一系列接受该技术治疗的患者，结果患者满意度很高。
临床问题/证据级别：治疗性研究，IV级
