Face reconstruction using lateral intercostal artery perforator-based adipofascial free flap

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Anatomy

Background:

• Facial soft tissue deficiency presents a reconstructive challenge.
• Adipofascial free flaps are utilized for facial contour restoration.
• The efficacy of lateral intercostal artery perforator-based flaps for this purpose requires investigation.

Purpose of the Study:

• To determine the efficacy of lateral intercostal artery perforator-based adipofascial free flaps for facial reconstruction.
• To evaluate this technique in patients with facial soft tissue deficiency.

Main Methods:

• Retrospective study of five patients undergoing facial reconstruction.
• Flap design centered on perforators of the lateral intercostal artery.
• Dissection included Scarpa's fascia and elevation of the adipofascial flap with perforators.

Main Results:

• Dominant perforators identified in the sixth to eighth intercostal spaces.
• Seventh or eighth intercostal artery perforators were used for free flaps.
• Mean pedicle artery diameter was 1.36 mm, mean length 61.4 mm; one case of partial fat necrosis, no severe complications.

Conclusions:

• This is the first study on lateral intercostal artery perforator-based adipofascial free flaps for facial contour reconstruction.
• The flap technique proved effective for restoring facial symmetry.
• Considered a viable alternative for severe facial soft tissue deficiency.