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Segmental reconstruction of the face.
1Departments of Medicine and Pathology, Cardinal Bernardin Cancer Center, Loyola University Stritch School of Medicine, Maywood, Illinois 60153, USA. jrobin5@lumc.edu
Summary
Segmental facial reconstruction using local flaps and grafts, dividing defects by cosmetic units, yields better aesthetic results and fewer complications than single-unit repairs. This approach preserves facial contours and function effectively.
Area of Science:
- Plastic Surgery
- Dermatologic Surgery
- Facial Anatomy
Background:
- Aesthetic facial reconstruction demands understanding of regional anatomy and tissue dynamics.
- Innovative use of adjacent tissue is crucial for preserving function and cosmetic units.
Purpose of the Study:
- Compare reconstruction of one cosmetic unit versus multiple units after Mohs surgery.
- Evaluate acute complications, function, and aesthetic outcomes.
- Assess techniques placing scars at cosmetic unit junctions using flaps and grafts.
Main Methods:
- Prospective analysis of 500 facial defect repairs over 10 years.
- Mobilization of tissue within cosmetic units using primary closure or local flaps (advancement, rotation, transposition).
- Segmental repair for defects bridging units, combining flaps and grafts, with scar placement at unit junctions.
Main Results:
- Segmental repair with flaps/grafts resulted in fewer unfavorable scar placements compared to single-unit flap repair.
- Segmental repair demonstrated lower flap loss rates than single-unit repairs.
- Advancement flaps restored contours; skin grafts prevented distortion in areas with minimal contour loss.
Conclusions:
- Segmenting wounds based on facial cosmetic units aids reconstruction planning.
- This approach facilitates tissue replacement with similar tissue for consistent aesthetic outcomes.
- Facial contours were successfully restored without distorting surrounding structures.