Reconstruction of large facial defects using a sensate superficial circumflex iliac perforator flap based on the lateral cutaneous branches of the intercostal nerves.

Abstract

Extensive composite facial defects present a surgical challenge because both functional and esthetic results must be considered simultaneously. Free flap transfer is a good option for extensive facial defects. However, the major concern regarding free flap reconstructions of facial defects is the bulkiness of the flaps. The use of a superficial circumflex iliac perforator (SCIP) flap, first reported in 2004, has many advantages including the availability of a thin, hairless skin paddle. In addition, the use of a sensate SCIP flap based on the lateral cutaneous branches of the intercostal nerves has recently been reported, which can potentially contribute to improved quality of life. We present 2 cases of free sensate SCIP flap reconstruction for extensive facial defects after cancer resection. The flaps were successfully transferred for coverage of the defects with acceptable functional and esthetic results. Sensate SCIP flaps provide a good option for the reconstruction of large facial defects because they are thin and hairless and offer an acceptable color match. These sensate flaps based on the branches of the intercostal nerves are easily obtainable, the donor site is in a concealed area, and primary closure is possible.