Repair of facial scars using free and pedicle-expanded deltopectoral flaps

This study aimed to evaluate the effectiveness and long-term outcomes of free and pedicled, expanded deltopectoral flaps with perforation of the internal thoracic artery to repair facial scars. This retrospective review was of 37 patients who presented between June 2013 and June 2019 with various types of facial scar. Ten patients received a free expanded deltopectoral flap and 27 a pedicled, expanded deltopectoral flap. During the stage-one operation, the expander was implanted into the deltopectoral area and fully expanded by normal saline injection. In stage two, the facial lesions were incised, and the free or pedicled flap transferred to reconstruct the defect. Flap necrosis did not occur in the 10 patients treated with free flaps. Two patients need to have the pedicle trimmed three months after surgery because it had become bloated. Distal necrosis occurred in five of 27 patients who received a pedicled, expanded deltopectoral flap. Healing by conservative treatment was noted in two cases and healing after skin grafting was documented in the other three. All 37 patients achieved satisfactory results. A pedicled, expanded deltopectoral flap appears to be a reliable and safe option for the treatment of facial scars.