Lip Reconstruction Using Buccal Fat Pad Free Graft: A Clinical Series

Background/Objectives: Maxillofacial volumetric deficits are often treated using structural fat grafting with autologous free fat grafts. The buccal fat pad (BFP) is commonly used as a pedicled flap for limited oral cavity applications. This study explores its use as a free graft for reconstructing deformities in the upper and lower lips caused by trauma or tumor resections. Methods: Five patients underwent soft tissue defect reconstruction using a free fat graft from the BFP, following standard surgical procedures. Techniques for harvesting, transferring, and evaluating aesthetic and functional outcomes up to three months post-surgery are detailed, with long-term follow-up extending to an average of 20 months (range 12–24 months). Results: Initial post-operative assessments showed lip asymmetry due to edema and excessive graft volume. Partial necrosis was observed within 1–2 weeks, typical of tissue healing. By 4–5 weeks, mucosal revascularization occurred, with desired lip volume and functionality achieved between 8–12 weeks. Long-term follow-up averaging 20 months demonstrated excellent graft stability with no volume regression beyond the vermilion border in all patients. Conclusions: The BFP as a free graft offers advantages such as high survival rates and easy harvesting. It effectively restores lip function, volume, and aesthetics. Challenges include graft manipulation, retention, potential fibrosis, and volume unpredictability. Future refinements in technique and follow-up are necessary to overcome these issues, enhancing the reliability of BFP for lip reconstruction.