Facial contouring with parascapular free flap: A case series of 22 cases
Background: The facial asymmetry correction in complex craniofacial malformations presents a challenging problem for reconstructive surgeons. Progressive hemifacial atrophy (HFA) and hemifacial microsomia (HFM) can manifest in different grades of severity. Most patients require only soft-tissue augm...
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| Format: | Article |
| Language: | English |
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2013-09-01
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| Series: | Indian Journal of Plastic Surgery |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.4103/0970-0358.122020 |
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| _version_ | 1850110074555465728 |
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| author | Guru Dayal Singh Kalra Ram Krishna Gupta |
| author_facet | Guru Dayal Singh Kalra Ram Krishna Gupta |
| author_sort | Guru Dayal Singh Kalra |
| collection | DOAJ |
| description | Background: The facial asymmetry correction in complex craniofacial malformations presents a challenging problem for reconstructive surgeons. Progressive hemifacial atrophy (HFA) and hemifacial microsomia (HFM) can manifest in different grades of severity. Most patients require only soft-tissue augmentation. Free flaps are the best option for correction of severe facial soft-tissue deficiency. Materials and Methods: Twenty-two patients of HFM and HFA were included in this study from January 2006 to March 2009 in the Department of Plastic and Reconstructive Surgery, SMS Medical College and Hospital. In all cases, atrophy correction was done using de-epithelialised parascapular free flap with the de-epithelialised surface was placed under the skin. A small skin paddle was taken for monitoring. Results: All cases were reconstructed with de-epithelialised parascapular free flap. There was no flap loss in this series. Hematoma was noted in five cases. Debulking and removal of skin paddle were done in all cases after 6 months. Atrophy recurrence was not observed in any of the cases on follow-up. Conclusion: Contouring of face in cases of HMF and HFA is satisfactorily done with the parascapular free flap. It gives better cosmetic results with minimal donor site morbidity. Facial vessels are better recipient vessels for anastomosis. Keeping de-epithelialised surface of flap under the skin helped in preventing sagging. |
| format | Article |
| id | doaj-art-47fecfd22dcf4a2f8e044e8497ccbfd3 |
| institution | OA Journals |
| issn | 0970-0358 1998-376X |
| language | English |
| publishDate | 2013-09-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | Indian Journal of Plastic Surgery |
| spelling | doaj-art-47fecfd22dcf4a2f8e044e8497ccbfd32025-08-20T02:37:55ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Plastic Surgery0970-03581998-376X2013-09-01460356156710.4103/0970-0358.122020Facial contouring with parascapular free flap: A case series of 22 casesGuru Dayal Singh Kalra0Ram Krishna Gupta1Department of Plastic and Reconstructive Surgery, SMS Hospital and Medical College, Jaipur, Rajasthan, IndiaDepartment of Plastic and Reconstructive Surgery, SMS Hospital and Medical College, Jaipur, Rajasthan, IndiaBackground: The facial asymmetry correction in complex craniofacial malformations presents a challenging problem for reconstructive surgeons. Progressive hemifacial atrophy (HFA) and hemifacial microsomia (HFM) can manifest in different grades of severity. Most patients require only soft-tissue augmentation. Free flaps are the best option for correction of severe facial soft-tissue deficiency. Materials and Methods: Twenty-two patients of HFM and HFA were included in this study from January 2006 to March 2009 in the Department of Plastic and Reconstructive Surgery, SMS Medical College and Hospital. In all cases, atrophy correction was done using de-epithelialised parascapular free flap with the de-epithelialised surface was placed under the skin. A small skin paddle was taken for monitoring. Results: All cases were reconstructed with de-epithelialised parascapular free flap. There was no flap loss in this series. Hematoma was noted in five cases. Debulking and removal of skin paddle were done in all cases after 6 months. Atrophy recurrence was not observed in any of the cases on follow-up. Conclusion: Contouring of face in cases of HMF and HFA is satisfactorily done with the parascapular free flap. It gives better cosmetic results with minimal donor site morbidity. Facial vessels are better recipient vessels for anastomosis. Keeping de-epithelialised surface of flap under the skin helped in preventing sagging.http://www.thieme-connect.de/DOI/DOI?10.4103/0970-0358.122020hemifacial atrophyhemifacial microsomiaparascapular flap |
| spellingShingle | Guru Dayal Singh Kalra Ram Krishna Gupta Facial contouring with parascapular free flap: A case series of 22 cases Indian Journal of Plastic Surgery hemifacial atrophy hemifacial microsomia parascapular flap |
| title | Facial contouring with parascapular free flap: A case series of 22 cases |
| title_full | Facial contouring with parascapular free flap: A case series of 22 cases |
| title_fullStr | Facial contouring with parascapular free flap: A case series of 22 cases |
| title_full_unstemmed | Facial contouring with parascapular free flap: A case series of 22 cases |
| title_short | Facial contouring with parascapular free flap: A case series of 22 cases |
| title_sort | facial contouring with parascapular free flap a case series of 22 cases |
| topic | hemifacial atrophy hemifacial microsomia parascapular flap |
| url | http://www.thieme-connect.de/DOI/DOI?10.4103/0970-0358.122020 |
| work_keys_str_mv | AT gurudayalsinghkalra facialcontouringwithparascapularfreeflapacaseseriesof22cases AT ramkrishnagupta facialcontouringwithparascapularfreeflapacaseseriesof22cases |