ABSTRACT
Microvascular free tissue transfer has become a popular reconstructive option for a wide range of complex head and neck defects. Although highly effective in achieving wound closure, this technique frequently introduces skin paddles with inherent differences in thickness, color, and texture. In resurfacing of cutaneous facial defects, such disparity often leads to inferior aesthetic results. For patients, poor appearance following head and neck reconstruction can become a significant source of distress and add additional burden to their recovery. This article describes several options available in the postoperative setting to improve the appearance of transferred skin paddles. Regional tissue rearrangement with the submental and posterior scalping flaps is discussed in detail.
KEYWORDS
Microvascular reconstruction - tissue expansion - submental flap - posterior scalping flap - scar revision
REFERENCES
-
1
Gonzalez-Ulloa M, Castillo A, Stevens E et al..
Preliminary study of the total restoration of the facial skin.
Plast Reconstr Surg.
1954;
13
151-161
-
2
Gonzalez-Ulloa M.
Reconstruction of the face covering by means of selective skin in regional aesthetic units.
Br J Plast Surg.
1956;
9
212-221
-
3
Hudson D A, Arasteh E.
Serial tissue expansion for reconstruction of burns of the head and neck.
Burns.
2001;
27
481-487
-
4
MacLennan S E, Corcoran J F, Neale H W.
Tissue expansion in head and neck burn reconstruction.
Clin Plast Surg.
2000;
27
121-132
-
5
Chun J T, Rohrich R J.
Versatility of tissue expansion in head and neck burn reconstruction.
Ann Plast Surg.
1998;
41
11-16
-
6
Hoffmann J F.
Tissue expansion in the head and neck.
Facial Plast Surg Clin North Am.
2005;
13
315-324
-
7
Martin D, Pascal J F, Baudet J et al..
The submental island flap: a new donor site. Anatomy and clinical applications as a free or pedicled flap.
Plast Reconstr Surg.
1993;
92
867-873
-
8
Pistre V, Pelissier P, Martin D et al..
Ten years of experience with the submental flap.
Plast Reconstr Surg.
2001;
108
1576-1581
-
9
Vural E, Suen J Y.
The submental island flap in head and neck reconstruction.
Head Neck.
2000;
22
572-578
-
10
Demir Z, Kurtay A, Sahin U et al..
Hair-bearing submental artery island flap for reconstruction of mustache and beard.
Plast Reconstr Surg.
2003;
112
423-429
-
11
Faltaous A A, Yetman R J.
The submental artery flap: an anatomic study.
Plast Reconstr Surg.
1996;
97
56-60
-
12
Arena S.
The posterior scalping flap.
Laryngoscope.
1977;
87
98-104
-
13
Mandell D L, Genden E M, Biller H F et al..
Posterior scalping flap revisited.
Arch Otolaryngol Head Neck Surg.
2000;
126
303-307
-
14
Draelos Z D.
Camouflaging techniques and dermatologic surgery.
Dermatol Surg.
1996;
22
1023-1027
-
15
Draelos Z K.
Cosmetics in the postsurgical patient.
Dermatol Clin.
1995;
13
461-465
-
16
Mostafapour S P, Murakami C S.
Tissue expansion and serial excision in scar revision.
Facial Plast Surg.
2001;
17
245-252
-
17
Traquina A C.
Micropigmentation as an adjuvant in cosmetic surgery of the scalp.
Dermatol Surg.
2001;
27
123-128
-
18
Angres G G.
Blepharopigmentation and eyebrow enhancement techniques for maximum cosmetic results.
Ann Ophthalmol.
1985;
17
605-611
-
19
Coessens B, Van Geertruyden J, De Mey A.
Surgical tattooing as an aesthetic improvement in facial reconstruction with a free radial forearm flap.
J Reconstr Microsurg.
1993;
9
331-334
-
20
Furuta S, Hataya Y, Watanabe T et al..
Vermilionplasty using medical tattooing after radial forearm flap reconstruction of the lower lip.
Br J Plast Surg.
1994;
47
422-424
Grigoriy MashkevichM.D.
Department of Otolaryngology, Head and Neck Surgery, New York Eye and Ear Infirmary
310 East 14th Street, New York, NY 10003
