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Extensive Facial Reconstruction Using Thickness-controlled Perforator Free Flaps.

Jong-Woo Choi1, Joo-Seok Park1, Ji-Hee Kim2

  • 1Department of Plastic and Reconstructive Surgery, Ulsan University College of Medicine, Asan Medical Center, Seoul, Republic of Korea.

Plastic and Reconstructive Surgery. Global Open
|November 11, 2020
PubMed
Summary

This study introduces a personalized strategy for extensive facial defect reconstruction using a combination of local and free flaps. This approach aims to improve outcomes for complex facial reconstructions, enhancing treatment effectiveness.

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Area of Science:

  • Plastic and Reconstructive Surgery
  • Facial Reconstruction Techniques

Background:

  • Small to medium facial defects are manageable with local flaps for aesthetic matching.
  • Extensive facial defects necessitate advanced techniques like free flaps, including perforator free flaps.

Purpose of the Study:

  • To propose a personalized strategy for reconstructing extensive facial defects.
  • To overcome limitations of current methods for large-scale facial reconstruction.

Main Methods:

  • Retrospective analysis of 79 extensive facial surface reconstruction cases (defect size > 40 cm²).
  • Data collected from 2005 to 2019 on defect size, location (upper, middle, lower face), and reconstruction method.
  • Development of a personalized reconstruction procedure based on flap selection and thickness-controlled perforator flap elevation.

Main Results:

  • Analysis of 323 total flap reconstructions, focusing on 79 extensive facial defects.
  • Detailed breakdown of defect locations: 24 upper third, 43 middle third, 12 lower third, and 4 involving multiple facial thirds.
  • Informed the development of a tailored reconstruction strategy for extensive facial defects.

Conclusions:

  • A novel facial reconstruction strategy is presented, integrating flap selection, thickness-controlled perforator flap elevation, and combined local and free flaps.
  • This personalized approach is expected to enhance the treatment and resolution of extensive facial defects.