Expanded Forehead Flaps for Reconstruction of Different Faciocervical Units

Wang, Qianwen; Song, Wan; Hou, Dianju; Wang, Jiaqi

doi:10.1097/prs.0000000000001157

Cited by 43 publications

(39 citation statements)

References 12 publications

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“…15,16 By combining skin expansion treatment, nasal reconstruction with an expanded forehead flap can achieve better outcomes and more satisfactory subunit presentation. 8,17 However, the recovery of perioral scars is still controversial. The most commonly reported treatments to recover the upper lip are skin grafts and pedicle flaps.…”

Section: Discussionmentioning

confidence: 99%

A Strategy for Integrative Reconstruction of Midface Defects Using an Extended Forehead Flap

Zhou

Gao

Tan

et al. 2021

Facial Plastic Surgery & Aesthetic Medicine

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Background: Midface reconstruction is challenging because the structures and deformities involved are complicated. In this study, we present a strategy for integrally reconstructing nasal and midface defects, including hair-bearing defects, using extended forehead-expanded flaps. Methods: From 2015 to 2018, a total of 22 patients with midface defects underwent reconstruction with extended forehead-expanded flaps. The far end of the expanded flap, which included scalp hair, was used to cover the upper lip defect (Type 1). In cases with large perioral defects (Type 2), we designed two separate supratrochlear artery flaps, one with a shorter pedicle for nasal reconstruction and the other with a longer pedicle for partial reconstruction. The pedicle of the longer flap was saved for upper lip recovery after pedicle interruption. Results: Among the 22 patients (13 male and 9 female), 17 were caused by burns and 5 by trauma. Nineteen patients had Type 1 defects, and three had Type 2 defects. The average postoperative follow-up was 17.6 -4.3 months. Patient satisfaction was excellent in most patients. Conclusions: Our extended forehead flap strategy can achieve aesthetic recovery of nasal and perioral defects with a single expansion treatment. The expanded flap can be flexibly designed to fit diverse midface defects.

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Section: Discussionmentioning

confidence: 99%

A Strategy for Integrative Reconstruction of Midface Defects Using an Extended Forehead Flap

Zhou

Gao

Tan

et al. 2021

Facial Plastic Surgery & Aesthetic Medicine

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“…Interestingly, there were 18 (18/7009; 0.25%) complications related to port site leakage arising from three separate studies included in this systematic review . In one study, the expanders were salvaged by exteriorizing the buried port, and the connective tube was occluded with a clip.…”

Section: Discussionmentioning

confidence: 99%

Complications of tissue expansion in the head and neck

et al. 2019

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Background The authors aim to present a comprehensive review detailing the present state of evidence with regard to complications following tissue expansion in the head and neck. Methods A systematic literature search was conducted to identify all studies reporting complications of tissue expansion in the head and neck between 2000 and 2019. Subgroup comparisons based on expander locations and planes were conducted. Results A total of 7058 patients were included. Tissue expansion was associated with an overall complication rate of 8.73% (616/7058). The most common complications were extrusion (207/7009; 3.0%) and hematoma (200/7009; 2.9%). Overall complications were highest in the scalp (65/238; 27.3%) and lowest in the mastoid (347/5688; 6.1%). Complications were more common with expansion in the non‐subcutaneous plane (63/590; 10.7%). Conclusion In the absence of large clinical trials, systematic reviews such as these can help inform clinical guidelines and provide practitioners with an evidence‐based reference to improve informed consent.

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“…Second, expansion technology permits an increase in the surface area of the donor tissue up to 1.5 to 2 times the size of the nonexpanded tissue. 25 Expansion of scarred forehead skin, because of previous forehead flaps or external causes, can establish structurally and aesthetically appropriate tissue for use in additional forehead flaps. 10 Due to the progressive, interval nature of expansion, the process can range from 10 to 18 weeks to obtain appropriate tissue length, requiring the patient to attend multiple inpatient expansion sessions.…”

Section: Relevant Anatomymentioning

confidence: 99%

“…10 Due to the progressive, interval nature of expansion, the process can range from 10 to 18 weeks to obtain appropriate tissue length, requiring the patient to attend multiple inpatient expansion sessions. 25 The high compliance demand may produce a physical and psychological burden on the patient, but a subset of patients with extensive defects are willing to make the sacrifice.…”

Section: Relevant Anatomymentioning

confidence: 99%

Approach to Reconstruction of Nasal Defects

Başağaoğlu

Ali

Hollier

et al. 2018

Seminars in Plastic Surgery

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The nose is the most central and anterior projecting facial feature. Therefore, the presence of a defect is easily noticeable to the untrained eye. Return of the defect to the original form is an achievable end goal of reconstruction, necessitating appropriate reformation of three-dimensional geometry, proper establishment of symmetry, and excellent color and texture match to the adjacent structures. Regarding its physiological importance, disruption of the normal function may cause respiratory obstruction and contribute to patient distress. To achieve successful repair, preoperative preparation must consider the location, the layers involved, and the size of the defect. Prompt and well-organized repair minimizes the occurrence of progressive necrosis and severe late-stage deformity. Here the authors provide a framework to approach various nasal defects and provide a review of the novel ideologies and techniques. The workhorse of nasal repair, the forehead flap, is discussed independently due to the breadth of innovation.

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Expanded Forehead Flaps for Reconstruction of Different Faciocervical Units

Abstract: Therapeutic, IV.

Cited by 43 publications

References 12 publications

A Strategy for Integrative Reconstruction of Midface Defects Using an Extended Forehead Flap

A Strategy for Integrative Reconstruction of Midface Defects Using an Extended Forehead Flap

Complications of tissue expansion in the head and neck

Approach to Reconstruction of Nasal Defects

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