Total cheek resurfacing with split ascending neck flap: A new approach

Grishkevich, Viktor M.

doi:10.1016/j.burns.2014.08.011

Cited by 6 publications

(2 citation statements)

References 34 publications

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“…9 According to the reconstructive elevator, it would be appropriate to skip a rung of the ladder in such cases when greater problem-solving skills are needed. 10 The cervical flap is considered the workhorse for facial reconstruction 11 and has multiple advantages. First, the neck skin is most similar to the residual facial skin in terms of texture, color, and thickness.…”

Section: Discussionmentioning

confidence: 99%

Using an Expanded Cervical Flap With an Overlapping Tissue Expansion Technique to Resurface Middle and Lower Facial Defects

Luo

2023

Journal of Craniofacial Surgery

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Background: Extensive facial burn scars are a tragedy for patients and often pose a great challenge to surgeons because of the high esthetic and functional demands. For patients with healthy skin in the neck region, a cervical flap is highly recommended for facial resurfacing; however, the skin on the midline of the neck often needs more expansion than that on either side, especially for the treatment of large facial defects. The sufficient longitudinal soft tissue in the anterior neck ensures a normal neck shape as well as a normal range of cervical extension, rotation, and lateral flexion. To overcome this, we developed an expanded cervical flap with an overlapping tissue expansion technique to gain more length centrally. Methods: First, 2 tissue expanders were embedded in the anterior neck region overlapping each other at the midline of the neck. After adequate inflation of the expander, the expanded flap was dissected and rotated to repair defects in the middle and lower face. The anchor position of the flap was placed on the horizontal line of the thyroid cartilage to restore the cervicomental angle. Results: Sixteen patients were treated with this method in this single-center study. All defects affected the middle and lower face, with an area ranging from 135 to 185 cm2, and were caused by a massive facial burn. Among them, 12 patients suffered ectropion of the lower lip, 3 suffered limited mouth opening due to scar contraction, and one patient had a cervicomental adhesion. The area of the expanded flap was approximately 163 to 266 cm2. The average period of expansion was 89.5 days. Patients were followed up after the operation, with the follow-up period ranging from 6 to 12 months. In all cases, good defect coverage was achieved, with primary closure of the donor sites and a good postoperative cervical configuration. Conclusion: We conclude that the expanded cervical flap with the overlapping tissue expansion technique proved to be a reliable method for facial skin reconstruction with functional and aesthetic improvement.

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Section: Discussionmentioning

confidence: 99%

Using an Expanded Cervical Flap With an Overlapping Tissue Expansion Technique to Resurface Middle and Lower Facial Defects

Luo

2023

Journal of Craniofacial Surgery

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“…The process generally takes between 3 and 5 months. Alternatively, Grishkevich 18 describes a three-staged split ascending neck flap. First, a CT or CF flap is elevated and transposed to repair the bottom half of the defect.…”

Section: Regional Flapsmentioning

confidence: 99%

Approach to Reconstruction of Cheek Defects

Başağaoğlu

Bhadkamkar

Hollier

et al. 2018

Seminars in Plastic Surgery

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The cheek is the largest facial unit with a prominent position on the face. Trauma, burns, and the resection of skin cancers constitute common sources of injury, potentially resulting in defects that, through natural healing, produce noticeable scarring. Surgical repair focuses on the reformation of three-dimensional geometries, proper establishment of symmetry, and the minimization of color and texture discrepancies to the surrounding. Defects located in this region may extend to the orbital, nasal, or buccal units and cause unique structural and functional disturbances. Furthermore, without appropriate repair, full-thickness defects involving the buccal mucosa may result in oral dysfunction. In this article, the authors provide a framework to approach various cheek defects and provide a review of the host of ideologies and techniques.

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