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Nose and Lip Graft Variants: A Subunit Anatomical Study
Jérôme Duisit1,2, Louis Maistriaux1,2, Alexander Gerdom1,2
1Brussels, Belgium.
Plastic and Reconstructive Surgery
|November 16, 2017
Summary
Facial subunit transplantation is feasible by isolating the distal facial artery for nose and upper lip grafts. This approach allows for safe, independent procurement of nasal and labial subunits for reconstructive surgery.
Area of Science:
- Plastic surgery
- Vascular surgery
- Anatomy
Background:
- Facial subunit grafting is an evolving concept in vascularized composite tissue allotransplantation.
- Current surgical designs for facial subunit grafts require further refinement.
Purpose of the Study:
- To investigate the possibility of dividing face transplants into distinct morphologic and functional subunits.
- To assess the vascular supply to nasal and labial subunits for independent harvesting.
Main Methods:
- Dissection of the facial artery and its branches in 20 adult cadavers.
- Assessment of nasolabial perfusion using dye injections and fluoroscopy.
- Microangiography computed tomographic analysis and fluoroscopic assessment of harvested grafts.
Main Results:
- The distal facial artery can independently perfuse the entire nose, septum, and upper lip.
- A dense anastomotic network exists between the distal facial and superior labial arteries.
- Safe procurement of bilabial subunits was possible even when the superior labial artery was excluded from the nasal subunit.
Conclusions:
- Demonstrates the feasibility of harvesting nasal and labial subunits, either isolated or combined.
- Findings support applications in autologous replantation, allotransplantation, and tissue engineering.
- Enables precise reconstructive strategies for partial face retransplantation.
