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Pre-expanded Anterolateral Thigh Perforator Flap for Phalloplasty
Salvatore D'Arpa1, Britt Colebunders1, Filip Stillaert1
1Department of Plastic and Reconstructive Surgery, Ghent University Hospital, De Pintelaan, 185, K12C, Gent 9000, Belgium.
Clinics in Plastic Surgery
|November 30, 2016
Summary
The anterolateral thigh (ALT) perforator flap offers an alternative phalloplasty technique, potentially improving donor site aesthetics. Pre-expansion enables primary closure, avoiding skin graft scars and enhancing patient outcomes.
Area of Science:
- Reconstructive surgery
- Microsurgery
- Urology
Background:
- The radial forearm flap, a common method for phalloplasty, results in noticeable scarring.
- The anterolateral thigh (ALT) perforator flap is an alternative with potentially better aesthetic outcomes.
- Donor site morbidity remains a concern with ALT flaps, often requiring skin grafting.
Purpose of the Study:
- To evaluate the efficacy of pre-expanded anterolateral thigh (ALT) perforator flaps in phalloplasty.
- To assess the benefits of pre-expansion for primary donor site closure.
- To explore the use of computed tomography angiography for precise perforator localization.
Main Methods:
- Pre-expansion of the ALT flap was performed.
- Computed tomography angiography was utilized for preoperative perforator mapping.
- Expander placement was achieved through two small incisions.
- Primary closure of the donor site was performed after flap harvest.
Main Results:
- Pre-expansion facilitated primary closure of the ALT donor site.
- This approach avoided the need for skin grafting and associated scarring.
- Computed tomography angiography enabled accurate placement of expanders.
- The ALT flap provides a viable alternative to the radial forearm flap with improved donor site cosmesis.
Conclusions:
- Pre-expansion of the ALT perforator flap is a valuable technique for phalloplasty.
- It allows for primary donor site closure, minimizing scarring and improving aesthetic results.
- Preoperative perforator localization using CT angiography ensures safe and efficient flap elevation.
