Answer to: "Comment: Insights into the Management of Trapdoor Deformity After Facial Skin Flap Reconstruction"

We thank the authors for their interest and insightful comments on our recent article. We would like to take this opportunity to reiterate and clarify several key points. The variability in triamcinolone acetonide (TCA) dosages and treatment schedules reflects the current lack of standardized protocols; reported doses range from 20 to 40 mg/mL, depending on the surgeon's clinical experience. No significant complications, including cutaneous atrophy, have been reported. We recommend deep injection into the subcutaneous adipose tissue and maintaining approximately 15 days between sessions, for a maximum of six treatments. TCA therefore remains the first-line therapy for trapdoor deformity (TD), pending further studies to better define uniform treatment protocols. Regarding laser therapy, current evidence is insufficient to establish specific parameters or standardized regimens. Concerning prevention, we reaffirm the critical importance of meticulous surgical planning, while acknowledging that the pathophysiology of TD is multifactorial and that preventive measures, although essential, cannot entirely eliminate its occurrence. In persistent cases, surgical correction may be considered according to patient expectations and needs. Further studies are warranted to refine treatment protocols and optimize clinical outcomes.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266 .