Augmented facelift flap for aesthetic reconstruction of posttraumatic facial defects

Saha S

Pdf Page Numbers :- 40-46

Srinjoy Saha^1,*

¹Department of Plastic Surgery, Apollo Gleneagles Hospital, Kolkata, India

*Corresponding author: Dr. Srinjoy Saha, MBBS, MS, MRCS, MCh (Plast), Apollo Gleneagles Hospital, Day Care Building, 2nd Floor, 58 Canal Circular Road, Kolkata 700054, India. Phone: +91 9874633896; Email: ss@medi.ac

Received 21 January 2020; Revised 9 March 2020; Accepted 20 March 2020; Published 31 March 2020

Citation: Saha S. Augmented facelift flap for aesthetic reconstruction of posttraumatic facial defects. J Med Sci Res. 2020; 8(2):40-46. DOI: http://dx.doi.org/10.17727/JMSR.2020/8-6

Copyright: © 2020 Saha S. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Introduction: Reconstructing posttraumatic facial defects to achieve aesthetically pleasing results is challenging. Different flaps, including many modifications of cheek flaps, are commonly performed, but several problems persist.

Aim: To evaluate the effectiveness of an augmented facelift flap for reconstructing posttraumatic facial defects. Fundamentally a rotation-advancement flap inspired by extended facelift markings and deep-plane facelift dissection, it incorporates retroauricular and cervical tissues whenever necessary.

Materials and methods: Ten patients (eight males, two females) with cheek, lateral orbit, and lower eyelid defects were reconstructed with augmented facelift flaps between January 2009 and December 2019. Size of defects ranged between 10.5 to 27 cm², and patients age between 21 to 78 years (mean, 49.3). Deep-plane facelift dissection was performed for extensive facial defects and subcutaneous dissection for smaller ones. Flap design was based on the principles of extended facelift surgery with necessary extensions. Meticulous dissection and anchoring ‘key sutures’ in four different facial regions were vital in preventing complications.

Results: Augmented facelift flap aptly reconstructed defects over the medial cheek, lateral orbit, and lower eyelid with aesthetically pleasing results. Nine patients (90%) healed well without any long-term complications. Among short-term complications, superficial necrosis was found in one patient (10%) and mild venous stasis in three patients (30%). Flap loss and infection were absent. Lower eyelid ectropion and deep marginal necrosis occurred in one patient (10%). Overall, patient satisfaction scores ranged between 50-90 percent (mean, 78%).

Conclusion: Augmented facelift flap successfully reconstructed posttraumatic facial defects over the cheek, lateral orbit, and lower eyelids with satisfying aesthetic results.

Keywords: Cheek surgery; cheek flaps; eyelid injuries; eyelid surgery; facial dissection methods; reconstructive surgical procedures; surgical flaps; wound healing