Restoration of Lower Facial and Neck Esthetics by Application of Pre-Expanded Bipedicle Scalp and Free Scapular Flaps.

Abstract

To introduce the surgical procedures and experiences in restoration of lower facial esthetics for a male and a female patients who suffered from burn injuries. The difference of surgical methods which varied from sexes were discussed. The clinical data of the patients was collected and retrospectively analyzed. The cervical contracture was repaired by pre-expanded free scapular flaps with sufficient pliable tissue for large defects. Moreover, for the male patient, prefabricated double pedicle scalp flap was applied to rebuild the beard region. The patients were followed up for 2 years. Surgical procedures and outcomes were detailed in the article. All the flaps were survived well. The facial hair-bearing area of the man was recovered with natural appearance. The reconstructed mental cervical angels and mandibular margins were clear. The neck extension mobility was improved. The 2 patients were satisfied with the outcomes of the treatments. The treatments of facial and neck scar varied from sexes and different requirements. For male patient, the combination of scalp and scapular flaps was a feasible method to achieve natural beard and cervical appearance. For female patient, bilateral expanded scapular flaps could meet the demands of large tissue supply and a relative hidden donor site.