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Fasciocutaneous SMAS Island Flap for Large Facial Defect Reconstruction
Simon J Madorsky1, Jonah S Brand1, Orr A Meltzer1
1Skin Cancer and Reconstructive Surgery (SCARS) Center, Newport Beach, California, USA.
Facial Plastic Surgery & Aesthetic Medicine
|December 11, 2024
Summary
Superficial musculoaponeurotic system (SMAS) island flaps offer a reliable method for reconstructing large facial defects. Both full and partial flaps demonstrated good advancing distance and low rates of vascular compromise.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Facial Anatomy
Background:
- Traditional reconstruction of large facial defects often involves cervicofacial rotation flaps.
- Superficial musculoaponeurotic system (SMAS) island flaps present an alternative for facial defect reconstruction.
Purpose of the Study:
- To evaluate the advancing distance of SMAS island flaps.
- To assess the vascular reliability of SMAS island flaps in reconstructing large facial defects.
Main Methods:
- Retrospective case series of patients with facial defects ≥ 3 cm reconstructed with fasciocutaneous SMAS island flaps (2009-2023).
- Analysis of flap advancing distance and incidence of vascular compromise.
- Comparison of full and partial island flap modifications.
Main Results:
- The mean flap advancing distance was 3.8 cm (SD 1.1).
- Flap ischemia occurred in 8% of cases (3 out of 36 patients).
- Smokers in the study did not experience flap ischemia.
Conclusions:
- Fasciocutaneous SMAS island and partial island flaps are dependable for reconstructing large cheek defects (≥ 3 cm).
- Anterior pedicle flaps are suitable for anterior defects, while posterior pedicle flaps are better for posterior defects.
