Functional Restoration of Complex Segmental Middle Third Facial Defect Using Tensor Fascia Lata and Lipofilling

Composite defects in the middle third of the face have devastating effects on a patient's life and social impacts. Several techniques have been described for the restoration of facial defects. The dynamic reconstruction of such defects mainly comprises a complex two-stage procedure and/or microsurgery, functional muscle transfer for restoration of facial animation, and filling the defects. A novel idea for the dynamic reconstruction of the complex segmental midfacial defects includes employing a fascial interposition graft to bridge the gap between the proximally innervated remnants of the facial muscle supplied by the facial nerve and the distal paralyzed perioral muscle, which is simultaneously combined with lipofilling to obtain a good contour and functional restoration.