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The subcutaneous cervicofacial flap revisited.
William G Austen1, Brian M Parrett, Amir Taghinia
1Division of Plastic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Annals of Plastic Surgery
|January 23, 2009
Summary
The subcutaneous cervicofacial flap is a reliable option for cheek reconstruction, showing low rates of flap necrosis and ectropion. This technique offers excellent patient satisfaction for midface soft tissue defects.
Area of Science:
- Plastic Surgery
- Dermatologic Surgery
Background:
- The cervicofacial flap is a preferred method for midface soft tissue defect reconstruction.
- Deep plane dissection is often recommended, but the subcutaneous approach remains common.
Purpose of the Study:
- To analyze the complications and outcomes of subcutaneous cervicofacial flaps used for cheek reconstruction.
- To evaluate the efficacy of the subcutaneous approach compared to other techniques.
Main Methods:
- A retrospective review of 32 patients who underwent subcutaneous cervicofacial flaps for cheek defects after Mohs micrographic excision.
- Analysis of complication rates, including flap necrosis and ectropion, and patient satisfaction.
Main Results:
- A low complication rate was observed: 9% minor flap tip/edge necrosis and 3% minor long-term ectropion.
- 31 out of 32 patients reported satisfaction with the reconstruction results.
- The mean defect size was 7.2 x 5.8 cm with a mean follow-up of 32 months.
Conclusions:
- The subcutaneous rotation-advancement cervicofacial flap is an excellent choice for cheek reconstruction.
- It demonstrates comparable flap necrosis rates and potentially lower ectropion rates than the deep plane technique.
- This method yields high patient satisfaction for midface soft tissue defects.