“…Augmentation with dermal fat grafts, other soft tissue autografts, and acellular dermal matrix alone or in combination with local tissue rearrangement has been described with generally favorable results. Concerns, however, include variable graft take, graft displacement, and persistent firmness or lumpiness of the upper lip (Chen et al, 1995; Rohrich et al, 2000; Stal and Hollier, 2002; Patel and Hall, 2004; Staebel and Verheyden, 2009; Wakami et al, 2010; Lee and Koh, 2012; Tabrizi et al, 2015). After CL repair, scarring at the site of notching can prevent adequate lip expansion and compromise of the vascular bed after graft placement, resulting in poor graft position and graft take (Eremia and Newman, 2000; Stal and Hollier, 2002; Duskova and Kristen, 2004; Zellner et al, 2015; Baum et al, 2017; Jones et al, 2017; Koonce et al, 2018).…”