title: Technical and anatomical considerations of face harvest in face transplantation.
abstract: Total face transplantation may become a reconstructive option in the treatment of patients with acquired facial deformity. Here, 2 face-harvesting techniques are presented in a fresh human cadaver model. In technique 1, the skin and soft tissue of the face is harvested by dissecting in a subgaleal, sub-SMAS, subplatysmal plane. In technique 2, the entire soft tissue and the bony structures of the midface are harvested by dissecting in a subperiosteal plane and performing a Le Fort III osteotomy. Each face was harvested successfully as a bipedicled flap based on the external carotid arteries, the external jugular veins, and the facial veins. Each of these 2 techniques is a theoretically viable approach to face harvest for composite allograft transplantation. These techniques represent the 2 extremes of which tissues can be harvested while maintaining vascular integrity. Each will address different reconstructive needs.
authors.affiliation: Division of Plastic, Reconstructive, Maxillofacial, and Oral Surgery, Duke University Medical Center, Box 3181, Durham, NC 27710, USA.
authors.forename: Alessio
authors.initials: A
authors.lastname: Baccarani
authors.forename: Keith E
authors.initials: KE
authors.lastname: Follmar
authors.forename: Steffen P
authors.initials: SP
authors.lastname: Baumeister
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Marcus
authors.forename: Detlev
authors.initials: D
authors.lastname: Erdmann
authors.forename: L Scott
authors.initials: LS
authors.lastname: Levin
mesh_terms: D002102:Cadaver; D005145:Face / Q000033:anatomy & histology*; D006801:Humans; D013524:Surgical Flaps; D020858:Tissue and Organ Harvesting / Q000379:methods*