An anatomic comparison of the skin of five donor sites for dermal fat graft

Kim performed more than 3,000 augmentation rhinoplasties using the dermal f at graft. He preferred the sacral area as the donor site over other areas b ecause the dermis is thick and the fat is more compact. The authors conduct ed a comparative study of the thickness of the epidermis and dermis, and th e numbers of fibroblasts and fibrocytes in the dermis of the abdominal wall , groin, lateral gluteal area, gluteal fold, and sacrum of 7 adult cadavers . The sacrum had the thickest epidermis (86.1 +/- 7.8 mum) and dermis (1,51 0.7 +/- 201.7 mum), and the groin had the thinnest epidermis (57.3 +/- 22.9 mum) and dermis (783.3 +/- 244.5 mum), The dermal thickness of the abdomen , lateral gluteal area, and gluteal fold was 913.3 +/- 271.7 mum, 1,018.7 /- 305.6 mum, and 1,107.0 +/- 272.6 pm respectively, The sacral dermis was significantly thicker than the other four sites (p < 0.008), and the groin dermis was the thinnest (p < 0.039). The number of fibroblasts and fibrocyt es in the sacral area and the gluteal skin folds was significantly higher t han the other areas (p < 0.05). The sacral area, gluteal fold, and lateral gluteal region had relatively thicker panniculus adiposus than the abdomen and groin. The panniculus adiposus of the sacral skin was especially well d eveloped and was comprised of several compact layers that were connected by parallel, thick collagen fibers. The authors conclude that the sacral skin is a suitable donor site for dermal grafting because its dermis has more f ibroblasts and fibrocytes than the other areas studied, and its dermis is m ore viable and durable.