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Evolution of cervicofacial flaps: From classical reconstruction to Freestyle Multiperforator Island Flap
Oswaldo J Gómez1,2,3, Carlos E Ruiz1,2, Erika Padilla2
1Plastic Surgery Unit, Universidad Nacional de Colombia, Bogotá, Colombia.
JPRAS Open
|January 6, 2026
Summary
The Freestyle Multiperforator Island Flap (FMIF) provides a versatile and cost-effective solution for facial reconstruction. This technique ensures reliable blood supply and minimizes donor site complications, offering a safe alternative for patients.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
Background:
- Introduces the Freestyle Multiperforator Island Flap (FMIF), a novel, customizable, subcutaneously-based flap for facial reconstruction.
- Highlights the flap's versatility due to extensive vascular territories supplied by dermal and facial plexuses.
Purpose of the Study:
- To evaluate the safety, versatility, and outcomes of the FMIF in facial reconstruction.
- To present a cost-effective alternative for reconstructive surgery.
Main Methods:
- Retrospective case series of 34 patients (37 flaps) undergoing cheek defect reconstruction between 2012 and 2022.
- Analysis of demographic profiles, defect etiology, flap characteristics, and postoperative outcomes.
Main Results:
- Malignant tumors were the primary indication (83.7%), including squamous cell carcinoma, basal cell carcinoma, and melanoma.
- The parotid-masseteric subunit was the most common reconstruction site (25 flaps).
- Major complications were infrequent (5 flaps), with no total flap loss reported.
Conclusions:
- The FMIF is a safe, versatile, and cost-effective option for facial reconstruction with reliable perfusion and minimal donor-site morbidity.
- Further comparative and anatomical studies are needed to validate its efficacy and role in reconstructive surgery.
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