Subunit-Based Intraflap Debulking Technique for Secondary Contouring After Free Flap Reconstruction.

Area of Science:

• Plastic surgery
• Reconstructive surgery
• Aesthetic surgery

Background:

• Secondary debulking is often necessary after free flap reconstruction, especially for flaps spanning multiple anatomical subunits.
• Traditional debulking methods struggle with central bulkiness and preserving natural contours.
• A novel subunit-based intraflap debulking technique was developed to address these challenges.

Purpose of the Study:

• To evaluate the safety and effectiveness of a subunit-based intraflap debulking technique for secondary contouring after free flap reconstruction.
• To assess the technique's ability to restore natural anatomical subunit borders.

Main Methods:

• Retrospective review of patients undergoing free flap reconstruction and subsequent subunit-based intraflap debulking (2021-2025).
• The technique involves intraflap incisions along subunit borders to remove central redundant tissue.
• Postoperative outcomes, including complications and healing time, were evaluated.

Main Results:

• Twenty-two cases, primarily lower extremity reconstructions (foot), were treated with the technique.
• The superficial circumflex iliac artery perforator flap was frequently used initially.
• No postoperative complications were observed, with a median healing time of 14 days.
• All patients reported satisfaction with aesthetic results.

Conclusions:

• The subunit-based intraflap debulking technique is a safe and effective method for secondary contouring in selected free flap cases.
• It allows for effective central debulking while restoring natural subunit boundaries.
• This approach enhances aesthetic outcomes after reconstructive surgery.