Carrillo TE, Wong RG, Ángeles CJL, Ángeles VE, Montes RD

Language: Spanish
References: 10
Page: 5-10
PDF size: 919.02 Kb.

ABSTRACT

The bilateral hemifacial flap design is a versatile alternative that allows for facial reconstruction of the mental and submental regions due to loss of lipocutaneous tissue, such as in cases of facial trauma from deep friction, gunshot wounds, or necrotizing fasciitis, to name a few. It also reduces vascular complications associated with flaps, as it is an advancement flap, not a rotation flap. This technique respects the biological and aesthetic principles of flap design, with the advantages of preserving the direction of facial hair growth and facial expression lines, while preserving the specific characteristics and features of the patient's face. This design, being a lipocutaneous flap, only allows reconstruction due to loss of skin and fat in the mental and submental region. This being its benefit, it is also a disadvantage for constructions that require myocutaneous thickness. However, in clinical cases where a smaller flap thickness is required, the surgeon has the possibility of manipulating it's thickness from the dissection when lifting the flap or of thinning it, at the time of presenting it in it's forward movement towards the midline of the face, allowing for symmetry since the tissue characteristics of the flap must adapt to the different anatomical reliefs, for example; if there in less fat volume in the chin area and the mandibular basal border, the author suggests thinning the flap thickness in these areas to better express the facial features.

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