Bipedicled Expanded Cervical Postauricular Combined Flap or Bipedicled Expanded Cervical Flap for Facial...

Large facial reconstruction is a complicated surgical procedure. The purpose of this study was to develop 2 procedures for large facial reconstruction: an expanded cervical postauricular combined skin flap and a bipedicled expanded cervical skin flap.

Two patients with large facial nevus lesions were selected for reconstruction. In 1 case, an expanded cervical postauricular combined flap with a bipedicle was designed; the upper pedicle was based at the temple region, the lower pedicle was based at the neck. In another case, an expanded cervical-only flap with a bipedicle was designed; the lower pedicle was based at the neck and the upper pedicle was based on healthy facial skin and a nevus lesion skin. All donor sites were closed simultaneously. Both patients underwent a second operation to cut the upper pedicle and repair the facial defect that resulted from the nevus lesion excision, using healthy skin to form a skin flap. The authors also formed a free skin graft from the scalp portion of the tubed pedicle to repair the facial defect where the flap could not reach.

Both patients were treated successfully. All flaps survived, without infection or necrosis. Scarring was minimal and the aesthetic and functional outcomes were good.

This technique provides a large source of skin, proximal to the lesion, as well as good blood supply, especially to the distal end of the flap. It is a safe and reliable alternative for the treatment of large facial nevus lesions.