The Evolution of Complex Microsurgical Midface Reconstruction: A Classification Scheme and Reconstructive Algorithm

Orbito-malar reconstruction after oncological resection represents one of the most challenging facial reconstructive procedures. Until the last few decades, rehabilitation was typically prosthesis based with a limited role for surgery. The advent of microsurgical techniques allowed large-volume tissue reconstitution from a distant donor site, revolutionizing the potential approaches to these defects. The authors report a novel surgery-based algorithm and a classification scheme for complete midface reconstruction with a foundation in the Gillies principles of like-to-like reconstruction and with a significant role of computer-aided virtual planning. With this approach, the authors have been able to achieve significantly better patient outcomes.