Purpose: The aim of this study was to examine the indications and results of autologous dermis-fat grafts in the reconstruction of maxillofacial soft-tissue defects.

Materials and Methods: A total of 93 patients with dermis-fat graft reconstruction due to a soft tissue defect in the head and neck region were enrolled in this retrospective clinical study between March 2002 and January 2017. They were classified into the subgroups ‘parotid surgery’, ‘orbital surgery’, and ‘facial surgery’. All the patients were evaluated for wound complications, and the general indications were discussed.

Results: In all, 96 dermis-fat grafts were performed in 93 patients. A total of 34 complications that arose in 30 patients were assessed. The dermis-fat graft was primarily transplanted in 50 cases and secondarily in 46. Of the patients, 90 showed well-integrated dermis-fat grafts. A major complication occurred in three patients.

Conclusion: Dermis-fat grafts for the reconstruction of maxillofacial soft-tissue defects represent a reliable method with a low rate of major complications. The graft can be used as a primary as well as secondary transplant. Especially in parotid and orbital surgery, the dermis-fat graft appears to be a transplant of choice. It can also be used as an alternative in facial surgery, lip enhancement, and special individual cases.