Reconstruction of moustache and ala of the nose with a single forehead flap. 2020

S M Balaji, and Preetha Balaji
Department of Oral and Maxillofacial Surgery, Balaji Dental and Craniofacial Hospital, Chennai, Tamil Nadu, India.

Reconstruction of critical-sized defects of composite facial units is a challenging one. This is amplified when facial hair-bearing areas are included. A case of reconstruction of multiple midfacial defects is presented. Initially, defective jaws were addressed. Later, appropriate modification of existing extended paramedical forehead flap to sequentially reconstruct defective lip, moustache, and parts of alae are described. The flap design was such that hair-bearing areas were used to reconstruct moustache while the nasal alar defect was reconstructed using the non-hair-beating forehead skin. Finally, dental implants were also placed. The technique was reliable, giving minimal donor site deformity but with maximum result. However, it is a multi-stage procedure. The paper also describes the challenges of midfacial unit reconstruction as handled in this case.

UI MeSH Term Description Entries
D009666 Nose A part of the upper respiratory tract. It contains the organ of SMELL. The term includes the external nose, the nasal cavity, and the PARANASAL SINUSES. External Nose,External Noses,Nose, External,Noses,Noses, External
D005145 Face The anterior portion of the head that includes the skin, muscles, and structures of the forehead, eyes, nose, mouth, cheeks, and jaw. Faces
D005546 Forehead The part of the face above the eyes. Foreheads
D006197 Hair A filament-like structure consisting of a shaft which projects to the surface of the SKIN from a root which is softer than the shaft and lodges in the cavity of a HAIR FOLLICLE. It is found on most surfaces of the body. Fetal Hair,Hair, Fetal,Lanugo,Fetal Hairs,Hairs,Hairs, Fetal
D013524 Surgical Flaps Tongues of skin and subcutaneous tissue, sometimes including muscle, cut away from the underlying parts but often still attached at one end. They retain their own microvasculature which is also transferred to the new site. They are often used in plastic surgery for filling a defect in a neighboring region. Island Flap,Island Flaps,Flap, Surgical,Flaps, Surgical,Pedicled Flap,Surgical Flap,Flap, Island,Flap, Pedicled,Flaps, Island,Flaps, Pedicled,Pedicled Flaps

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