Microvascular free flaps in soft-tissue augmentation of the head and neck

The disadvantage of traditional methods for reconstruction of soft-tissue deficits providing symmetric restoration of head and neck contour are the need for multiple stages in the case of pedicle flaps and the unpredictable atrophy and resorption in the case of free nonvascularized dermis-fat grafts. In addition, unsightly donor defects may be an added disadvantage. A major use of free revascularized grafts and flaps is in the reconstruction of contour defects of the head and neck resulting from loss of soft tissue and bone. Soft-tissue augmentation can be achieved by the transfer of free cutaneous or musculocutaneous flaps. The ideal donor sites for such flaps are in areas of the body where large direct cutaneous or musculocutaneous flaps can be harvested with relatively long vascular pedicles, and where minimum morbidity and secondary deformity will occur from harvesting the flap. Microvascular flaps allow for tissue augmentation of the head and neck with restoration of symmetry without the problem of subsequent atrophy and resorption.