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Arch Craniofac Surg > Epub ahead of print
DOI: https://doi.org/10.7181/acfs.2021.00381    [Epub ahead of print]
Published online January 10, 2022.
Reconstruction of large facial defects using a combination of forehead flap and other procedures
Ryuck Seong Kim1  , Changryul Yi1,2  , Hoon Soo Kim3  , Ho Yoon Jeong1  , Yong Chan Bae1,2 
1Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Busan, Korea
2Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
3Department of Dermatology, Pusan National University School of Medicine, Busan, Korea
Correspondence:  Yong Chan Bae,
Email: baeyc2@hanmail.net
Received: 20 August 2021   • Revised: 6 September 2021   • Accepted: 16 December 2021
Abstract
Background
Reconstruction of large facial defects is challenging as both functional and cosmetic results must be considered. Reconstruction with forehead flaps on the face is advantageous; nonetheless, reconstruction of large defects with forehead flaps alone results in extensive scarring on the donor site. In our study, the results of reconstruction using a combination of forehead flaps and other techniques for large facial defects were evaluated.

Methods

A total of 63 patients underwent reconstructive surgery using forehead flaps between February 2005 and June 2020 at our institution. Reconstruction of a large defect with forehead flaps alone has limitations; because of this, 22 patients underwent a combination of procedures and were selected as the subjects of this study. This study was retrospectively conducted by reviewing the patients’ medical records. Additional procedures included orbicularis oculi musculocutaneous (OOMC) V-Y advancement flap, cheek advancement flap, nasolabial V-Y advancement flap, grafting, and simultaneous application of two different techniques. Flap survival, complications, and recurrence of skin cancer were analyzed. Patient satisfaction was evaluated using questionnaires.

Results

Along with reconstructive surgery using forehead flaps, nasolabial V-Y advancement flap was performed in nine patients, local advancement flap in three, OOMC V-Y advancement flap in two, grafting in five, and two different techniques in three patients. No patient developed flap loss; however, cancer recurred in two patients. The overall patient satisfaction was high.
Conclusion
Reconstruction with a combination of forehead flaps and other techniques for large facial defects can be considered as both functionally and cosmetically reliable.
Keywords: Basal cell carcinoma / Reconstructive surgical procedures / Skin neoplasms / Squamous cell carcinoma / Surgical flaps


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