One-year survival of AlloDerm allogenic dermal graft and fat autograft in lip augmentation

Background: Although many methods for cosmetic lip augmentation are available, none represents an ideal solution. Objective: A quantitative analysis of surgical lip augmentation was undertaken comparing AlloDerm (Lifecell Corp., Branchburg, NJ) allogenic dermal graft and autologous fat injection with autologous fat injection alone. Methods: Horizontal stab incisions were made at the vermilion border in the lateral commissure of the lip. A tunnel connecting the incision was created with a canthal awl by use of blunt dissection along the vermilion border in a submucosal/supraorbicularis muscle plane. AlloDerm grafts were affixed to the end of the awl, pulled through the tunnel, and held in place with interrupted 4-0 chromic sutures. Fat was injected into the lips in a “string-of-pearls” fashion, with approximately 0.5 to 0.8 mL used per pass. Volume measurements were taken at 1 month, 3 months, and 1 year after operation. Results: Mean vermilion show was substantially increased at 1 month after surgery in both groups. At 3 months, mean vermilion show was unchanged in the AlloDerm/fat group but decreased 0.6 mm in the fat-only group. At 12 months, mean vermilion show had decreased 0.2 and 1.0 mm, respectively, for these 2 groups. Measurements of lateral lip projection in the AlloDerm/fat group demonstrated a sustained increase at 3 and 12 months. Conclusions: AlloDerm used with injected autologous fat appeared to result in a long-lasting increase in vermilion show and lateral lip projection. Future studies with quantitative analysis of surgical outcomes can be used to compare various allograft implantation techniques and identify the optimum technique for maximum volume maintenance. (Aesthetic Surg J 2002;22:349-354.)