Dermis Graft
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The dermis is the thick, undersurface portion of the skin which makes up the bulk of this organ. It is very strong and can be used effectively as a grafted supportive material if it's external, "epidermal" cover is first removed.
This man had falcial palsy on his left side from injury to the facial nerve. He was elderly, and not a good candidate for re-animation surgery. It was elected to resuspend the face to try to produce better symmetry with the face in repose.

This is dermis removed from the groin after its surface covering of epidermis has been removed. (The purple color is from marking ink). Note that the dermis has been cut into many strands.

Through a hairline incision and small facial entries, the dermis was fixed to the tough, muscular layers of the temple and then tunneled to the undersurface of the skin at key points on the face. It was used to "haul up" the features of the jaw line and corner of the mouth

While some asymmetry persisted post-operatively, his face is much more symmetrical in repose.

2/21/00

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