Endoscopic abdominoplasty providing a perforator fat flap for treatment of hemi-facial microsomia.

A patient with a history of an extended unilateral hemifacial cleft desired the restoration of the buccal fat on the hollow cheeked side and also wished to reduce an abdominal bulge at the same time. The amount of tissue volume needed exceeded the possibilities of free autologous fat grafting, lipofilling and allogenic implants. Therefore a free fat flap with microvascular anastomoses harvested as part of a minimal invasive abdominoplastic procedure using an incision well hidden within the bikini zone was the most attractive surgical option. This is the first case reported, where the standard free deep inferior epigastric artery (DIEA) perforator flap was utilised.