Microvascular Free Transfer of Omentum to The Cheek
S. K. DAS
M. A. LESAVOY
The major problem of free omentum to the face for contour restoration is the late sagging of the omentum. For this reason, other procedures are being used, such as those described in preceding chapters, especially deepithelialized skin flaps.
The search for ideal tissue to reconstruct contour deformity in the face still goes on. Various autogenous and synthetic materials have been tried.
The size of the omentum is not a problem, and it has been shown that omentum is almost always present, with an average length of 25 cm and an average width of 33 cm. Omental size can be predicted from the sex, height, and weight of the patient (7, 8). Only in rare cases of total lipodystrophy is omental fat, as well as mesenteric fat, totally absent (9).
The structure and vascular anatomy of the omentum make it suitable for use in facial reconstruction (3, 8). The fatty structure gives it pliability and softness, and the distribution of omental vessels helps divide the omentum into vascular units. The right gastroepiploic vascular pedicle length ranges from 9 to 12 cm, and the size of the vessels ranges from 1.5 to 3 mm for artery and 2.5 to 3.5 mm for vein. The length of the pedicle permits the selection of donor vessels far away from the recipient site and allows for minimal size discrepancy with recipient vessels, such as the facial, superior thyroid, and superficial temporal vessels.