Versatility of Autologous Dermofat Grafts in Secondary Cleft Reconstructive Surgery: An Institutional Experience

BACKGROUND: Secondary cleft deformities involving the lip, nose, palate, and adjacent soft tissues are challenging to manage. Autologous dermofat grafting is used as an adjunct for soft-tissue augmentation and contour refinement. This study reviews the literature on dermofat application and presents our experience with its use. METHODS: A combined literature review and retrospective study was conducted to evaluate dermofat grafting in secondary cleft reconstruction. The literature review assessed its applications, whereas 46 patients with cleft lip and/or palate who underwent dermofat grafting at our center were reviewed for indications and outcomes. RESULTS: The literature supports dermofat grafting as a versatile adjunct for both aesthetic, structural, and functional correction. In our series, the indications were vermilion and nasal dorsum augmentation, oronasal fistula repair, Furlow palatoplasty, scar revision, and contour deformity correction. Patients demonstrated improved aesthetic contour with favorable functional outcomes in oronasal integrity and speech resonance. Donor-site morbidity was low, with occasional prolonged scar visibility and pigmentation changes. CONCLUSIONS: Dermofat grafting is a reliable adjunct in secondary cleft reconstruction, providing effective soft-tissue augmentation and structural support with low morbidity.