Reconstruction of the face after resection of arteriovenous malformations using anterolateral thigh perforator flap

Arteriovenous malformations are high flow lesions that remain a challenge in the field of plastic surgery, interventional radiology, and neurosurgery. This is especially true for large lesions requiring a comprehensive team approach. From March 2001 to August 2004, six patients with arteriovenous malformation having extensive involvement of the skin underwent selective embolization followed by resection and reconstruction with anterolateral thigh perforator flap. The age of patients ranged from 22 to 43 years (average, 29 years); four were male and two were female. The size of the defect ranged from 8 x 10 cm to 12 x 14 cm. During the follow-up period from 3 months to 41 months, two patients required ancillary procedures to improve their aesthetic appearances. All patients achieved acceptable contour, appearance, and sensation without any incidence of recurrences. The anterolateral thigh perforator flap provides a large, thin and sensible flap. The anatomy of the flap is relatively constant and reliable. Despite the extensive involvement of arteriovenous malformation of the face, with selective embolization, maximal resection, and coverage with a well-vascularized tissue, it can be safely removed and successfully reconstructed.