Latissimus dorsi free flap for restoration of facial contour defects

The treatment of facial asymmetries presents an aesthetic component of great importance. To correct facial contour defects, there are many therapeutic possibilities available, such as autologous tissue grafts and inorganic implants. The arrival of microsurgical techniques has improved the outlook for facial contour restoration. Among the tissues used are groin, escapular, and omentum flaps. This article introduces our experience with the latissimus dorsi free flap for the restoration of facial contour defects. Our experience is based on 7 patients affected with hemifacial microsomia and Romberg's disease. Operative planning, surgical procedure, and results are described. The use of the latissimus dorsi free flap is our procedure of choice for its greater adaptability in conforming to the shape of the defect, its long vascular pedicle, the abundance of available tissue, and minimal tendency to ptotic changes. At present we recommend this technique for replacement of soft tissue in severe defects of the face.