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Microsurgical Forehead Reconstruction.

Denis Ehrl1, P Niclas Broer, Paul I Heidekrueger

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The Journal of Craniofacial Surgery
|December 16, 2016
PubMed
Summary
This summary is machine-generated.

Forehead reconstruction using microsurgery is reliable for large defects. The gracilis muscle flap with skin graft offers superior aesthetic results and low complication risks, making it a preferred choice.

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Area of Science:

  • Plastic Surgery
  • Reconstructive Surgery
  • Microsurgery

Background:

  • Forehead reconstruction presents significant challenges, particularly for extensive defects where local tissues are insufficient.
  • Free flap coverage is often necessary for large or complete forehead defects, demanding advanced reconstructive techniques.

Purpose of the Study:

  • To develop an algorithmic surgical approach for microvascular forehead reconstruction.
  • To evaluate the surgical and aesthetic outcomes of using gracilis muscle or anterolateral thigh flaps.

Main Methods:

  • A retrospective case series of 15 patients undergoing microvascular free flap reconstruction for forehead defects.
  • Utilized gracilis muscle flaps (n=7) with split-thickness skin grafts and anterolateral thigh flaps (n=8).

Main Results:

  • Mean forehead defect size was 84.6 cm², often involving exposed bone.
  • All donor sites healed uneventfully; minor complications occurred in 3 patients requiring revision.
  • Microsurgical reconstruction proved reliable for complex and large forehead defects.

Conclusions:

  • Microvascular reconstruction is a dependable method for diverse forehead defects, especially large and complex ones.
  • The gracilis muscle flap with an unmeshed split-thickness skin graft is recommended for forehead reconstruction due to low risks and excellent aesthetics.