Contour refinements of free flaps for optimal outcome in oral reconstruction: combination of modified liposuction technique and w-plasty in one-stage procedure.
BACKGROUND
Bulkiness and unsightly scarring are the major complaints after oral cancer reconstruction with free flap transfer. Some debulking procedures, such as blunt-tipped cannula liposuction or staged excision, can result in some improvement, but these methods do not provide a one-stage procedure for flap thinning and scar revision due to the concern of flap ischemic change. All suction lipectomy methods were applied on flap resurfacing cases; no through-and-through defect case was used. The author used a nonstandard open-tip cannula for liposuction and w-plasty for scar revision in a one-stage operation in oral through-and-through defect cases. This method achieved excellent aesthetic results without complications.


METHODS
From January of 2004 to October of 2006, secondary debulking procedures were performed on 22 patients who had undergone reconstruction with free anterolateral thigh flaps. All flaps were on the cheek for oral cancer through-and-through defect reconstruction. Suction lipectomy with nonstandard open-tip cannula and w-plasty were performed.


RESULTS
All flaps survived well without any partial skin necrosis. Over 85% of patients were satisfied with the outcome.


CONCLUSIONS
This method can provide a one-stage debulking procedure for the cheek through-and-through defect after free flap reconstruction, and it achieves good aesthetic outcomes.
Huang
Shu-Hung
SH
Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Wu
Sheng-Hua
SH
Chang
Kao-Ping
KP
Wang
Wen-Her
WH
Lai
Ching-Hung
CH
Sun
I-Feng
IF
Lin
Sin-Daw
SD
Lai
Chung-Sheng
CS
D002610:Cheek / Q000601:surgery*; D002921:Cicatrix / Q000601:surgery; D004487:Edema / Q000209:etiology; D004954:Esthetics; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D015187:Lipectomy / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000601:surgery*; D009062:Mouth Neoplasms / Q000601:surgery; D017060:Patient Satisfaction; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000379:methods*; D016038:Skin Transplantation / Q000379:methods; D013524:Surgical Flaps / Q000473:pathology; D016896:Treatment Outcome