A Strategy for Integrative Reconstruction of Midface Defects Using an Extended Forehead Flap

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Craniofacial Surgery

Background:

• Midface reconstruction presents significant challenges due to complex anatomical structures and varied defect types.
• Traditional methods often struggle with extensive defects involving nasal and perioral regions, including hair-bearing areas.

Observation:

• A novel strategy utilizing extended forehead-expanded flaps was employed for integral reconstruction of nasal and midface defects in 22 patients.
• The technique involved using the expanded flap, incorporating scalp hair, for upper lip defects (Type 1) or employing dual supratrochlear artery flaps for larger perioral defects (Type 2).

Findings:

• The extended forehead flap strategy successfully reconstructed diverse midface defects, including those with hair-bearing requirements.
• Excellent aesthetic results and high patient satisfaction were reported, with an average follow-up of 17.6 months.
• The technique proved effective for defects resulting from burns (17 patients) and trauma (5 patients).

Implications:

• This approach offers a versatile and effective solution for achieving aesthetic recovery in complex midface and nasal reconstruction.
• The extended forehead flap technique allows for flexible adaptation to various defect morphologies with a single expansion treatment.
• This strategy holds potential for improving reconstructive outcomes in patients with significant facial deformities.