Synergic effect of buccal fat pad pedicled flap and dermal acellular matrix for large cheek defect

Introduction & Objectives: Reconstruction of large defects of the upper cheek defects still remains a challenge for the surgeon, than can apply different techniques. We present a new method involving the use of a dermal regeneration template to achieve an improved, faster healing of pedicled buccal fat flap in a 75-years-old woman affected by melanoma of the upper-middle cheek. The tumor involved soft tissue, zygomatic arch and periocular fact. Material & Methods: The choice of the surgical technique consisted first in the creation of a buccal fat pad to restore the important lack of tissue over the underlying bones, then in the positioning of a dermal acellular matrix. Three weeks later, once the neodermal formation was finished, a split thickness graft was placed. Results: This is a not yet described association that represents a good surgical option for the restoration of large cheeck defects that allows good functional and cosmetic result in older patient when minimal surgical invasion and operative duration are necessary because of a patient’s general condition. The post-operative course with this surgical technique was regular and a good functional result was achieved. Conclusions: This technique provides an adequate functional coverage, a restoration of soft tissue lacking and an acceptable cosmetic result without ectropion.