Local Flaps
Summary Local flaps can provide immediate definitive wound closure but at the expense of distant incisions and increased repair complexity. Although geometric flaps are well described and popular, the human…
Pedicled Flaps
Summary Two distinct flaps, the paramidline forehead flap and the nasolabial flap, are most suitable for nasal reconstruction. Although they should not be considered interchangeable, either pedicle flap can be…
Eyelid Reconstruction
Summary Normal eyelid structure and function is critical for ocular protection. Multiple aesthetic subunits coalesce in the periocular region. Complex anatomy can be broken down into two basic subunits: the…
Lip Reconstruction
Summary The lip has significant functional and aesthetic requirements. The upper and lower lips are different in both function and anatomy. The lower lip is somewhat featureless, while the upper…
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…
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…
