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Reconstruction of midface defects using local flaps: An algorithm for appropriate flap choice.

Jung Woo Chang1, Jung Han Lim, Jang Hyun Lee

  • 1Department of Plastic and Reconstructive Surgery, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, South Korea.

Medicine
|November 15, 2019
PubMed
Summary

This study presents a new algorithm for selecting local flaps in midface reconstruction. The algorithm guides surgeons to choose between perforator-based transposition flaps and VY advancement flaps for optimal patient outcomes.

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Area of Science:

  • Plastic Surgery
  • Reconstructive Surgery
  • Facial Anatomy

Background:

  • Local flap surgery is crucial for reconstructing midface defects, aiming for optimal skin color and texture match.
  • Choosing the correct flap is essential for successful midface defect reconstruction.

Purpose of the Study:

  • To introduce a novel algorithm for selecting appropriate local flaps in midface reconstruction.
  • To guide surgeons in choosing between perforator-based transposition flaps and VY advancement flaps.

Main Methods:

  • A retrospective study of 38 patients with midface defects between February 2013 and February 2019.
  • Defects >3cm were reconstructed with perforator-based transposition flaps.
  • Defects <3cm were reconstructed with VY advancement flaps or perforator-based transposition flaps based on location relative to the nasolabial fold (NLF).

Main Results:

  • The algorithm was applied to 38 patients, utilizing perforator-based transposition flaps in 22 cases and VY advancement flaps in 16 cases.
  • All flaps demonstrated successful survival without complications.
  • VY advancement flaps yielded superior aesthetic results and higher patient satisfaction compared to transposition flaps, with more natural contouring.

Conclusions:

  • A tailored approach based on patient condition and defect characteristics is key for selecting the most suitable local flap for midface reconstruction.
  • The proposed algorithm facilitates appropriate flap selection, leading to satisfactory reconstructive outcomes.