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

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.

[1]  I. Koshima,et al.  A sensate superficial circumflex iliac perforator flap based on lateral cutaneous branches of the intercostal nerves. , 2012, Journal of plastic, reconstructive & aesthetic surgery : JPRAS.

[2]  E. Rodriguez,et al.  A Reappraisal of the Free Groin Flap in Aesthetic Craniofacial Reconstruction , 2012, Annals of plastic surgery.

[3]  E. Funayama,et al.  Reconstructive considerations in the treatment of soft tissue sarcomas of the cheek. , 2010, Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale.

[4]  M. Mureau,et al.  Maximizing results in reconstruction of cheek defects. , 2009, Clinics in plastic surgery.

[5]  Lee-Wei Chen,et al.  Sensate Thoracodorsal Artery Perforator Flap: A Focus on Its Preoperative Design and Harvesting Technique , 2009, Plastic and reconstructive surgery.

[6]  K. Harii,et al.  Extensive actinomycosis of the face requiring radical resection and facial nerve reconstruction. , 2006, Journal of plastic, reconstructive & aesthetic surgery : JPRAS.

[7]  A. Nagai,et al.  Penile reconstruction with bilateral superficial circumflex iliac artery perforator (SCIP) flaps. , 2006, Journal of reconstructive microsurgery.

[8]  M. Mureau,et al.  Anterolateral Thigh Flap Reconstruction of Large External Facial Skin Defects: A Follow-Up Study on Functional and Aesthetic Recipient- and Donor-Site Outcome , 2005, Plastic and reconstructive surgery.

[9]  I. Koshima,et al.  Superficial Circumflex Iliac Artery Perforator Flap for Reconstruction of Limb Defects , 2004, Plastic and reconstructive surgery.

[10]  T. Nakatsuka,et al.  Comparison of innervated and noninnervated free flaps in oral reconstruction. , 1999, Plastic and reconstructive surgery.

[11]  Yuhei Yamamoto,et al.  Facial Reconstruction with Free‐Tissue Transfer , 1994, Plastic and reconstructive surgery.