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Scarpa's Fascial Fat Graft - A Novel Addition to the Lip Enhancement Algorithm

Michael Larsen MD Gordon Lee MD
The Ohio State University Medical Center
2013-03-20

Presenter: Michael Larsen

Affidavit:
The resident assisted in the operative case. All of the abstract/presentation is his original work, as well as the algorithm.

Director Name: Gregory Pearson

Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics

Background: The Plastic Surgeon must have many techniques at his disposal in order to optimally enhance a patient's lips, because a perfect or universally applicable technique does not exist. We present a new technique, the abdominal scarpa's fascial fat graft, which gives the plastic surgeon another valuable option in the appropriate patient. We then present a lip enhancement algorithm that can aid the plastic surgeon in selecting an appropriate option for a particular patient.
Methods: We harvested strips of scarpa's fascia with adherent fat from discarded muscle-sparing transverse rectus abdominis muscle (MS-TRAM) flap tissue. We used blunt-dissection to create submucosal tunnels in both the upper and lower lips. Then, we introduced the scarpa's fascial fat grafts into the submucosal tunnels using a tendon passer.
Results: On 1 year follow-up, the patient's lips retained much of their fullness. The lips were soft and without any contour deformities. The patient expressed satisfaction with the result. We, therefore, present a lip enhancement algorithm with inclusion of the Scarpa's fascial fat graft.
Conclusion: Because a perfect lip enhancement technique does not exist, the Plastic Surgeon needs to have many options at his finger tips by which he may optimally enhance the lips of a particular patient. Scarpa's fascial fat graft is a yet another source for lip enhancement. It fits into the lip enhancement algorithm as a viable option in those patients that are simultaneously undergoing abdominoplasty or reconstruction with a TRAM flap.

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