Subcutaneous pedicle flaps in facial repair.

Abstract

This study shows the importance of rotating subcutaneous pedicle flaps for a wide range of possibilities in face and nose reconstruction. The method described was studied and developed over 10 years in 305 patients with basocellular carcinoma of the face. This method uses areas with natural depressions and provides good aesthetic results, which are sometimes difficult to obtain using conventional reconstruction methods. Because of their circulatory nature, subcutaneous pedicle flaps can be performed on most parts of the face. The flap can be prepared from skin where there is cellular subcutaneous soft tissue (randomized vascularization), in which the facial circulation is tangential and vertical to the skin surface (i.e., like perforating arteries). These characteristics can be found in nasogenian wrinkles, the malar region, the upper and lower lips, and the chin. The flaps can not be prepared, however, from a region corresponding to the front of the face, the cervical, or the nose, where the necessary circulatory details and soft tissue are not available.