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Updated: Mar 7, 2026
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Surgical Approach to Full Soft Tissue Face Allograft Procurement for Vascularized Composite Allotransplantation
Published on: December 30, 2025
142
Watershed Areas in Face Transplantation.
Bahar Bassiri Gharb1,2, Russell S Frautschi1,2, Brianna C Halasa1,2
1Cleveland, Ohio; and Chicago, Ill.
Plastic and Reconstructive Surgery
|February 25, 2017
Summary
Facial artery-based allografts can compromise palate perfusion. A modified Le Fort III approach safely harvests maxillary artery allografts, preserving facial skeleton blood supply and reducing necrosis risk.
Area of Science:
- Craniofacial surgery
- Vascular anatomy
- Allograft transplantation
Background:
- The maxillary artery is crucial for facial skeleton vascularization.
- Harvesting facial allografts using the maxillary artery is challenging due to its deep location.
- Facial artery-based allografts may lead to compromised palate perfusion.
Purpose of the Study:
- To review allograft necrosis occurrence.
- To modify craniofacial techniques for reliable maxillary artery-based facial allograft harvest.
Main Methods:
- Systematic literature search for allograft perfusion and necrosis data.
- Anatomical study using 25 fresh cadaver heads.
- Comparison of traditional Le Fort III approach with a modified technique for maxillary artery preservation.
Main Results:
- Facial artery allografts resulted in palatal fistulas or necrosis in 41% of patients.
- Traditional Le Fort III approach frequently injured the maxillary artery.
- The modified approach enabled direct visualization and preservation of the maxillary artery.
Conclusions:
- Facial artery-based allografts with Le Fort III components risk compromised palate perfusion.
- The modified Le Fort III approach facilitates safe maxillary artery dissection.
- This technique preserves arterial supply to the facial skeleton, improving allograft viability.
