Key Points
- BellaDerm available in multiple sizes, has shelf life of about three years
- Acellular dermal allograft is more easily cut, fashioned than a temporalis fascia graft
A 49-year-old female patient before (left) and five months after open rhinoplasty with a BellaDerm sheet used as an onlay graft overlying the nasal dorsum and tip structures, secondary to an extremely thin dorsal skin. (Photos credit: Maurice Sherman, M.D.)
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SAN DIEGO — Experience with an acellular hydrated dermal tissue allograft (BellaDerm, Musculoskeletal Transplant Foundation) indicates that it is a useful material for enhancing outcomes of rhinoplasty procedures, offering many benefits that make it a superior alternative to previous options for correcting problems in dorsal shape and appearance, according to Maurice Sherman, M.D. The product is derived from human skin obtained from individuals undergoing body-contouring surgery after massive weight loss. Donors are carefully screened and the allograft is prepared in a proprietary process that assures sterility, Dr. Sherman says.
BellaDerm is available in multiple sizes and can be stored at room temperature with a shelf life of about three years. The material is flexible and easily manipulated so that it can be used for augmentation of the nasal dorsum or to conceal irregularities of the bony cartilage component (especially improving the cosmetic outcome in patients with very thin nasal skin), he says.
A patient before (left) and three months after open rhinoplasty with tip reconstruction and a BellaDerm sheet used as an onlay dorsal graft, secondary to thinning of the dorsal skin.
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The benefit it provides is durability, because the material serves as a scaffold for in-growth of host collagen and vascular tissue, says Dr. Sherman, a private practitioner specializing in cosmetic, facial, plastic and reconstructive surgery at Del Mar Cosmetic Medical Center, Del Mar, Calif. He is also associate clinical professor of surgery, University of California, San Diego.
"There are many situations in rhinoplasty where a dorsal onlay graft is useful. The ideal graft material has been sought for years because the options available have suffered from a number of limitations," Dr. Sherman says. "This acellular dermal allograft offers a host of desirable features and appears to solve many of the concerns associated with previously used implant materials."
EXAMINING ACCESSIBILITY Accessibility is a key feature of the allograft. Ready-to-use off the shelf, it eliminates the need for harvesting temporalis fascia and the morbidity and possible permanent complications associated with that procedure, Dr. Sherman says.