The Reconstruction of Cheek Defect Using Tissue Expansion and Design of Flap Setting

Abstract

Reconstruction of large cheek defects using tissue expansion is a good option for surgeons. The aim of this design is to fully utilize the expanded flap and to conceal the scar in an inconspicuous area on the face. The authors developed a new flap design after tissue expansion which can be expanded more distally to cover the cheek defect. With the proper design of the expanded tissue, one can make full utilization of the flap to cover and reach a wider and more distal defect. The key of the design is to make a proper back cut and to rotate 180 degree upward so that the flap can stretch upward to fully cover the defect. (As described in Fig. 1). Eight patients with cheek defects were reconstructed using the new designed flap. The etiologies of the defects include vascular malformation, hairy nevus, scar contracture, and skin cancer excision. Good coverage with minimal scarring for cheek reconstructions were achieved in all eight patients. There were no flap loss or major complications, and all minor problems were treated by minimal procedures without long term sequelae. The reconstruction of cheek defect using tissue expansion can provide good quality of expanded tissue and obviate donor side morbidity.