Versatility of the Free Multipedicled Anterolateral Thigh Flap for Restoring Complex Facial Soft Tissue Defects

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Microsurgery

Background:

• Facial soft tissue injuries present significant reconstructive challenges.
• Material selection requires consideration of texture, color, composition, and properties.
• The anterolateral thigh (ALT) flap offers advantages for free flap reconstruction.

Purpose of the Study:

• To evaluate the utility of the anterolateral thigh (ALT) flap for complex facial defect reconstruction.
• To assess the efficacy of a multipedicled ALT flap design.

Main Methods:

• Retrospective case series of 23 patients undergoing facial reconstruction.
• Utilized the multiple-paddle ALT flap for chimeric reconstruction.
• Detailed analysis of perforator origin, flap thickness, and component usage.

Main Results:

• Average of 1.2 perforators per flap, primarily from the lateral circumflex femoral artery.
• Average skin flap thickness of 24.6 mm, thinned to 6.8 mm in most cases.
• High flap utilization for coverage, lining, and filling, with a low complication rate (4.0%).

Conclusions:

• The ALT flap is a versatile and effective option for complex facial defects.
• The multipedicled design allows for simultaneous reconstruction of multiple lost facial units.
• Mastery of multipedicled ALT flap techniques is essential for successful facial reconstruction.