Reconstruction Of Facial Soft Tissue Defects Research Articles

Facial Defects With Infraorbital and Zygomatic Area Reconstruction Using an Expanded Flap Based on the Orbicularis Oculi Muscle: A Long-Term Follow-up.

Reconstruction of facial soft-tissue defects may pose a dilemma for plastic surgeons, as the flaps must be reliable to obtain a natural appearance while minimizing donor site morbidities. This clinical study describes a reconstructive method for infraorbital and zygomatic defects using a pre-expanded rotation flap based on the orbicularis oculi muscle (OOM). The surgeries were subdivided into 2 stages. In the first stage of the operation, a 100 to 200mL expander was placed underneath the temporal area through a hairline incision. In the second stage, after adequate inflation of the expander, the pre-expanded rotation flap based on the OOM of the lower eyelid was raised from lateral to medial to cover the facial defects. In this single-center study from February 2010 to February 2017, 16 patients underwent facial defect reconstruction using the pre-expanded flap based on the OOM. All of the defects were located at the infraorbital and zygomatic regions, and their sizes ranged from 3.0 4.0 to 7.0 14.0cm. The causes of these defects included postburn scars (37.5%), melanocytic nevus (50%), and hemangiomas (12.5%). In all cases, good coverage was provided for the defects that were in the medial cheek or lower eyelids. There were no flap losses of any kind. There were no major complications, and all minor incidences were treated by minimal procedures. The patients were followed up after surgery, with the follow up ranging from 6 months to 108 months. The follow-up data included postoperative consultations, the defect size, the need for further procedures and the degree of satisfaction. The pre-expanded rotation flaps in the lateral facial area based on the OOM can ideally and safely be applied for facial defect reconstruction owing to their reliable blood supply and excellent texture match.

Reconstruction of facial soft tissue defects with free flaps by microsurgery

To investigate the method and indications for reconstruction of facial complicated soft tissue defects with free flaps by microsurgery. 37 patients (16 males and 21 females, aged from 1 to 54 years) with different size of facial soft tissue defects were reconstructed with free flaps, including 10 latissimus dorsi myocutaneous flaps, 3 thoracodorsal artery perforator flaps, 9 scapular flaps, forearm flaps and 9 postauricular flaps. The defects size ranged from 1 cm x 2 cm to 25 cm x 12 cm. Venous obstruction happened in 3 postauricular flaps, resulting partial necrosis in 2 flaps. All the other flaps survived completely. The cosmetic and functional results were both satisfactory. The facial complicated soft tissue defects can be treated successfully with free flaps by microsurgery. The wounds can be healed primarily with short recovery time and reliable cosmetic and functional result.