The Face Lift SMAS Plication Flap for Reconstruction of Large Temporofrontal Defects: Reconstructive Surgery Meets Cosmetic Surgery

Giovanni Zabbia, Roberto Pirrello, Adriana Cordova, Francesco Moschella, Salvatore D'Arpa, Salvatore D'Arpa, Francesco Moschella, Giovanni Zabbia, Roberto Pirrello, Daniel Kalbermatten, Adriana Cordova

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Abstract

Background: Reconstruction of large defects in the temporal region can beperformed with skin grafts or pedicled or free flaps. Results are often not optimalbecause of the patch of a skin graft, lack of availability of local flaps, and distantskin from free flaps. A technique for reconstruction of these defects with localtissue is presented in this article that uses superficial musculoaponeurotic system(SMAS) plication to allow wide advancement of a cervicofacial flap.Methods: Once the defect is outlined, a face-lift–like skin incision is used to raisethe flap. The SMAS is plicated with two purse-string sutures that relieve tensionon the flap and allow maximal advancement. Thirteen face-lift SMAS plicationflaps were used in 12 patients (mean age, 70.2 years) after cancer resection,which was bilateral in one case. Defects up to 8 cm in largest diameter can beclosed. In one case of an 8 6-cm defect, a 1 1.5-cm skin graft was necessary.Results: All flaps healed uneventfully, and no reoperation was necessary. Scarsare almost completely hidden and the cosmetic result is satisfactory. The asymmetricalface-lift effect fades out within 6 months.Conclusions: The face-lift SMAS plication (FLISP) flap allows reconstruction oflarge defects in the temporal region with a local flap providing an excellentcosmetic result and avoiding the need for distant tissue and multiple scarring.This flap provides an example of how reconstructive surgery and cosmeticsurgery are complementary and can be mutually beneficial. (Plast. Reconstr.Surg. 127: 2068, 2011.)
Lingua originaleEnglish
pagine (da-a)2068-2075
Numero di pagine8
RivistaPlastic and Reconstructive Surgery
Volume127
Stato di pubblicazionePublished - 2011

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All Science Journal Classification (ASJC) codes

  • Surgery

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