No abstract

The aesthetic and functional role of the human face can not be overemphasized. It is keystone in perception of self-identity and represents the most striking features of an individual's being. Being a place of concentration of major perceptive organs, like eyes, ears and nose, the face also has direct involvement in emotional and social communication. Facial disfigurements may present in different forms, varying from minor nuisances to severe debilitating problems. The main goals in reconstruction of severely deformed face include restoration of function, comfort and appearance. Nowadays we have plenty of surgical modalities to fulfill these tasks, including cadaveric face transplantation. However, neither of the procedures can be considered as fully consistent in terms of achievable results. Here we describe reconstruction of face by expanded supraclavicular flap. Two clinical cases are presented. We performed a three-stage reconstruction, which included implantation of tissue expander in supraclavicular area, subsequent transfer of a fasciocutanous flap onto the face, and finally, pedicle division of the flap with additional scar revision. A satisfactory fascial shape has been achieved. We believe that supraclavicular flap, prefabricated by expansion is a powerful tool for autologous reconstruction of face and can be successfully used in selected cases.

Dermatofibrosarcoma protuberans (DFSP) is a locally aggressive skin tumor. It usually occurs on the trunk and extremities and, only about 10% of cases DFSP are found on head and neck region. Presence of the tumor on the head challenges surgical treatment because of need in wide resections of limited scalp tissue. Recurrent cases of DFSP often possess possibility of bone and intracranial involvement that dictates even greater resection with simultaneous closure to prevent meningitis and other fatal complications. Control of the wound margins either by means of frozen sections or by Moh's technique is a keystone of successful treatment.Here we present a case of recurrent DFSP of the fronto-parietal area. The case is remarkable for intracranial extension of the tumor. Also we describe a rare use of bipedicle a. temporalis superficialis (visor) flap for reconstruction of composite defects of forehead resulted from wide resection of large recurrent DFSP lesion.