Extensive composite facial defects present a surgical challenge because both functional and esthetic results must be considered simultaneously Free flap transfer is a good option for extensive facial defects However, the major concern regarding free flap reconstructions of facial defects is the bulkiness of the flaps The use of a superficial circumflex iliac perforator (SCIP) flap, first reported in 2004, has many advantages including the availability of a thin, hairless skin paddle In addition, the use of a sensate SCIP flap based on the lateral cutaneous branches of the intercostal nerves has recently been reported, which can potentially contribute to improved quality of life We present 2 cases of free sensate SCIP flap reconstruction for extensive facial defects after cancer resection The flaps were successfully transferred for coverage of the defects with acceptable functional and esthetic results Sensate SCIP flaps provide a good option for the reconstruction of large facial defects because they are thin and hairless and offer an acceptable color match These sensate flaps based on the branches of the intercostal nerves are easily obtainable, the donor site is in a concealed area, and primary closure is possible

Reconstruction of large facial defects using a sensate superficial circumflex iliac perforator flap based on the lateral cutaneous branches of the intercostal nerves.

BACKGROUND One of the methods for midface soft-tissue defect reconstruction has been the cervicofacial flap. METHODS Cheek skin defects of 35 patients were reconstructed with cervicofacial flaps. This study was done from 2007 to 2011. Mean follow-up was 24 months. In these patients, tumors including 19 basal cell carcinomas, 11 squamous cell carcinomas, and 5 malignant melanoma were excised, and cheek reconstructions were done by this flap in defects of 5- to 8-cm diameter in 3 zones . We did some modifications in the cervicofacial flap. RESULTS In our experience, 35 patients aged 30 to 75 years (mean, 53 years), 16 women (46%) and 19 (54%) men, had a reconstruction with cervicofacial flap. Lesions included basal cell carcinoma (n = 19), malignant melanoma (n = 5), and squamous cell carcinoma (n = 11) in the cheek region. We performed periosteal malar bone anchoring suture of the flap in all cases and lateral canthopexy with this flap in 11 cases where lesions were in the suborbital or lateral periorbital region. CONCLUSIONS Cervicofacial flap with malar bone periosteal anchoring with or without lateral canthopexy is a good aesthetic choice for cheek skin reconstructions.

Experience with cervicofacial flap in cheek reconstruction.

Summary Joseph Gensoul is considered an important figure of the 19th century Lyonnais Medical School. His contribution to maxillofacial surgery and his legendary abilities secured him a place in the history of Medicine.

Joseph Gensoul's operation for sarcoma of the maxillary antrum, one century before Moore.

Large Cheek Defect Reconstruction With a Rhomboid Flap and Burow's Advancement Flap After Excision of a Basal Cell Carcinoma.

The face is an important structure, because it is the most visible part of the body and contains delicate and complex elements that are essential for aesthetics and functionality. Facial reconstruction of areas with substantial substance loss remains a surgical challenge. There are several repair options, with corresponding advantages and disadvantages. We present a case of a patient with substance loss of the total thickness of the cheek region who received mucosal and local skin flap surgery, with good results and functional preservation.

/pdf/mucosal-and-local-skin-flap-reconstruction-for-loss-of-4tvifrqejm.pdf

Mucosal and local skin flap reconstruction for loss of substance in the cheek region

Soft tissue sarcomas of the head and neck region are rare, and very little has been described about the reconstructive methods used after sarcoma resection of cheek soft tissue sarcomas. Reconstructive methods for cheek defects after sarcoma resection are presented and the possibilities, advantages, disadvantages, and expected results are described. A series of 3 patients with cheek soft tissue sarcomas were examined. Reconstructive methods included; one skin graft, a free forearm flap and a cervicofacial flap. All patients had lesions < 5 cm and low-grade tumours, and no case presented local recurrence or metastases. The choice of reconstructive methods depends mostly on the complexity of the defect. In cases comprising comparatively small or minor defects, reconstructions using local flaps, such as the cervicofacial flap, provide better aesthetic and functional results than either free flaps or skin graft.

Reconstructive considerations in the treatment of soft tissue sarcomas of the cheek

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Reconstructive considerations in the treatment of soft tissue sarcomas of the cheek