Subcutaneous bipedicle island flaps on the face.
ABSTRACT Since 1996, 13 patients have undergone the reconstruction of facial skin defects with subcutaneous bipedicle island skin flaps. The reasons for the surgery were basal cell carcinoma in 10 patients and benign skin tumor excision in three patients. All defects were reconstructed with subcutaneous bipedicle skin flaps without significant complications. Bipedicle subcutaneous skin flaps are a useful alternative for facial reconstruction.
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ABSTRACT: A method is described where the planned directional undermining of a subcutaneous triangular flap creates a long pedicle and in the process the flap is "unfolded" to increase its advancement. The flap can be undermined and advanced without any tension. This method is recommended where more conservative undermining is inadequate for mobilisation, particularly in larger defects and in the replacement of skin defects on the lower eyelid which needs to support the eyelid. This technique depends on the richness of the random blood supply in the head and neck regions and the availability of adequate depth of subcutaneous tissue for the development of a long pedicle. Using this method in 53 cases, it has been found possible to advance the flap way past the defect if so desired. Some minor disadvantages of this flap are also described.British Journal of Plastic Surgery 02/1988; 41(1):62-7. · 1.29 Impact Factor
Article: The extended V-Y flap.[show abstract] [hide abstract]
ABSTRACT: The extended V-Y flap is a modification of the V-Y advancement flap, which is very useful in closing defects following excision of facial lesions. The modification involves the addition of an extension limb onto the advancing edge of the standard flap. This limb is located adjacent to the area requiring reconstruction and is hinged down as a transposition flap on the end of the V-Y advancement flap to close the most distal portion of the defect. The extended V-Y flap has been found to be very effective in closing large defects in areas that typically have inadequate subcutaneous tissue to allow extensive mobilization of the standard V-Y advancement flap. It has been used effectively with excellent cosmetic results in the temporal, scalp, forehead, and nasal areas, providing a well-contoured and aesthetically pleasing reconstruction.Plastic & Reconstructive Surgery 09/1992; 90(2):275-80. · 3.54 Impact Factor
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ABSTRACT: Reconstruction of facial defects poses the interesting challenge of finding the most satisfactory flap both aesthetically and functionally. It requires not just a knowledge of the flap, but an ability to think and plan in three dimensions. Not all individuals possess this; thus, what is obvious and simple to one surgeon, poses a great and worrisome problem for another. This can be made easier by considering certain rules. First, excise the lesion properly and then think about the reconstruction. The presence of the defect crystallizes the thought process. Next, consider the topographic and functional anatomy of the face, the differences in skin color, presence of hair, and the "idea" lines for position of scars. The flap options are rotation, transposition, and advancement. The latter, on occasions, may be as an island. These movements must be fitted into the aforementioned requirements. In this way the best choice usually is reached. Remember, there is always a way out using a skin graft or tissue expansion.Clinics in Plastic Surgery 11/1997; 24(4):747-67. · 1.22 Impact Factor