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Regeneration and repair processes are critical in healing damages caused by injury, disease, and aging. In regeneration, the damaged tissue is entirely replaced with new growth that restores the original architecture and function. In contrast, tissue repair usually results in a fixed tissue architecture involving scar formation. Scars generally do not reestablish tissue function and may also exhibit structural abnormalities at the injury site.
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Updated: Jun 22, 2025

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Autologous Tissue Repair and Total Face Restoration.

Tao Zan1, Wenjin Wang1, Haizhou Li1

  • 1Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China.

JAMA Otolaryngology-- Head & Neck Surgery
|July 3, 2024
PubMed
Summary

This study presents a novel face prefabrication technique for total face restoration using autologous tissue. The innovative approach significantly improves patients' quality of life, aesthetic appearance, and functional status, offering a safe and effective reconstructive option.

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Area of Science:

  • Reconstructive Surgery
  • Tissue Engineering
  • Plastic Surgery

Background:

  • Total face restoration is a complex challenge in reconstructive surgery.
  • Autologous tissue reconstruction offers potential but requires innovative techniques.
  • Face prefabrication is an emerging concept for complex facial defects.

Purpose of the Study:

  • To evaluate the long-term outcomes of total face restoration using a standardized face prefabrication technique.
  • To assess the safety, efficacy, and patient satisfaction with this reconstructive approach.
  • To report on the use of 3D printing and indocyanine green angiography in conjunction with flap prefabrication.

Main Methods:

  • A retrospective study of 32 patients undergoing total face restoration between 2005 and 2022.
  • Involved flap prefabrication, tissue expansion, 3D printing, and flap transfer guided by indocyanine green angiography (IGA).
  • Patient-reported outcomes were assessed using validated questionnaires (SF-36, Aesthetic and Functional Status Score, EQ-5D-5L).

Main Results:

  • Significant improvements in quality of life, particularly social functioning and emotional stability.
  • Mean follow-up of 5.6 years showed substantial gains in aesthetic and functional status (P < .001).
  • High patient satisfaction, with 92% returning to work and overall improved self-reported health status.

Conclusions:

  • The standardized face prefabrication technique provides a safe and valid option for total face restoration.
  • The approach yields acceptable reconstructive and cosmetic outcomes with long-term patient benefits.
  • This innovative method enhances functional recovery and patient-reported quality of life.