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A 1-Year Follow-up of Clinical Observations and Histological Findings

Anthony P. Sclafani, MD; Thomas Romo III, MD; Andrew A. Jacono, MD; Steven A. McCormick, MD; Rubina Cocker, MD; Andrew Parker, MD

Arch Facial Plast Surg. 2001;3:101-103.

Objectives  To evaluate and compare the long-term clinical persistence and histological appearance of subdermally implanted acellular dermal graft (AlloDerm) sheets and intradermal type I bovine collagen cross-linked with glutaraldehyde (Zyplast).

Patients  Ten adult patients (5 men and 5 women; average age, 46 years; age range, 37-59 years) not allergic to bovine collagen.

Methods  AlloDerm sheets were implanted surgically in a subdermal plane in one postauricular crease, and Zyplast was injected intradermally on the opposite side. AlloDerm and Zyplast implants were digitally photographed and their apparent volumes calculated at 1, 3, 6, 9, and 12 months after implantation. A specimen was removed at 3 and 12 months and examined histologically for collagen persistence, host tissue invasion, and inflammatory reaction.

Results  The apparent implant volume of the AlloDerm sheets decreased during the first 6 months and then stabilized over the next 6 months. By contrast, Zyplast was progressively absorbed, with complete loss of clinical effect by 6 months. Histological analysis of implanted AlloDerm sheets demonstrated progressive repopulation of the graft with minimal inflammation.

Conclusions  AlloDerm sheets seem to provide stable soft tissue augmentation after an early period of resorption and are clearly superior to Zyplast injections for long-term, large-volume, soft tissue correction. Recommendations for clinical use include routine overcorrection, with subsequent augmentation delayed by at least 6 months.

From the Division of Facial Plastic Surgery (Drs Sclafani and Romo), and the Departments of Otolaryngology–Head and Neck Surgery (Drs Sclafani, Romo, Jacono, and Parker) and Pathology (Drs McCormick and Cocker), The New York Eye and Ear Infirmary, New York; and the Department of Otolaryngology–Head and Neck Surgery, New York Medical College, Valhalla (Drs Sclafani and Romo).

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Editorial Comment
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Arch Facial Plast Surg. 2001;3(2):103.
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