Nasal Reconstruction Based on Subunits
Summary Accurate determination of the nature of the defect is essential in anatomic-based reconstruction planning. In reality, a few basic techniques will manage a majority of defects. Complex defects most…
Reconstructive surgery
Split-Thickness Skin Grafting
Summary Split-thickness skin grafting can provide large volumes of color-matched skin for head and neck reconstruction with minimal donor-site morbidity. Split-thickness skin graft harvesting from the scalp provides thick color-matched…
Ear Reconstruction
Summary Do not let exposed cartilage become an issue, almost all cartilage defects with intact perichondrium will heal well secondarily. The majority of ear reconstruction cases can be done with…
Complex Nasal Defects
Summary There are two flaps most applicable to complex nasal defects—the nasolabial flap and the forehead flap. Only the forehead flap can provide enough robust tissue to reliably treat lining…
Cheek Reconstruction
Summary There are three anatomic zones, the suborbital, preauricular, and buccomandibular (zones 1, 2 and 3, respectively), to consider when reconstructing the cheek. Direct closure, even for large defects, often…
Cellular and Tissue-Based Wound Care
Summary The utility of cellular and tissue-based wound care products in soft-tissue facial reconstruction is dependent on careful patient selection and wound management. Cellular and tissue-based products can be used…
Scalp Reconstruction
Summary Very vascular, proceed with caution during in-office procedures. There is very little laxity, especially on the vertex. Scalp will tolerate significant tension on closure. For exposed calvarium, simple bone…
Local Flap Revisions
Summary The most frequently indicated revision for local flaps is correction of contour abnormalities. The final result is best if maximal scar maturation is achieved prior to revision. Alar contour…
Forehead Reconstruction
Summary Borders define the forehead. Heals very well secondarily. Can close under moderate tension. Heals well regardless of vertical or horizontal closure orientation. 11.1 Algorithm for Closure 11.1.1 General Considerations The forehead…
Pedicled Flap Revisions
Summary Contour abnormalities in pedicle flap reconstruction are common and easily managed with appropriate revision. Edema and soft-tissue contour abnormalities present at the time of flap division and inset will…
