Resurfacing of Face and Neck Using Superthin Thoracodorsal Artery Perforator Free Flaps

Area of Science:

• Microsurgery
• Plastic Surgery
• Reconstructive Surgery

Background:

• Facial and neck resurfacing presents unique challenges due to regional skin characteristics.
• Perforator-free flaps offer soft tissue but often fall short of cosmetic expectations due to color and bulk discrepancies.
• Superthin thoracodorsal artery perforator (TDAp) free flaps were employed to address these limitations.

Purpose of the Study:

• To evaluate the efficacy of superthin TDAp free flaps for facial and neck defect reconstruction.
• To assess the aesthetic outcomes and patient satisfaction with this reconstructive technique.

Main Methods:

• A cohort of 15 patients with facial and neck soft tissue defects underwent reconstruction using superthin TDAp free flaps between January 2012 and January 2020.
• A "pushing with pressure and cutting" technique was used to remove superficial fat, preserving only tissue around the perforator.
• Patient satisfaction was assessed via questionnaire regarding color, contour, and overall satisfaction at least 12 months post-surgery.

Main Results:

• Flap sizes varied (mean 126.3 cm²), with a mean thickness of 4.97 mm.
• All flaps demonstrated successful survival without complications.
• Patients reported high satisfaction with aesthetic results, and a significant increase in cervical range of motion was observed in burn scar contracture cases.

Conclusions:

• Superthin TDAp free flaps are a highly effective option for face and neck resurfacing.
• The technique yields large, thin flaps with superior color matching and robust vascularity.
• This method provides excellent aesthetic outcomes and functional improvement for patients.