title: Deep-planes lift associated with free flap surgery for facial reanimation.
abstract: Between April 1999 and April 2008, 37 patients with long-standing facial paralysis underwent a one-stage facial reanimation with neuromuscular free flaps: 28 patients (group A) underwent flap transposition only; 9 patients (group B) underwent a deep-planes lift (DPL) composed of the superficial muscoloaponeurotic system + parotid fascia at the time of facial reanimation. The postoperative and final results were compared between groups A and B, following the classification of Terzis and Noah (1997). Before the onset of contraction, only group B patients (100%) showed good or moderate symmetry at rest, while none of the patients of group A had a symmetric face. The respective final results for patients in groups A and B who already showed the onset of flap contraction were excellent in 28.6% and 44.5%, good in 42.9% and 33.3%, moderate in 10.7% and 22.2%, and fair or poor and fair in 17.8% and 0% of patients, respectively. The DPL allows immediate symmetry of the face at rest and contributes to upgrading the final static and dynamic results in facial reanimation with free muscular flaps.
authors.affiliation: Department of Maxillo-Facial Surgery, Galeazzi Hospital, University of Milano, Via R. Galeazzi 4, Milan, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Biglioli
authors.forename: Alice
authors.initials: A
authors.lastname: Frigerio
authors.forename: Luca
authors.initials: L
authors.lastname: Autelitano
authors.forename: Giacomo
authors.initials: G
authors.lastname: Colletti
authors.forename: Dimitri
authors.initials: D
authors.lastname: Rabbiosi
authors.forename: Roberto
authors.initials: R
authors.lastname: Brusati
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003238:Connective Tissue / Q000601:surgery; D005145:Face / Q000601:surgery; D005146:Facial Asymmetry / Q000209:etiology*; D005149:Facial Expression; D005152:Facial Muscles / Q000601:surgery*; D005154:Facial Nerve / Q000601:surgery*; D005158:Facial Paralysis / Q000150:complications* / Q000601:surgery*; D000071938:Fasciotomy; D005260:Female; D058752:Free Tissue Flaps; D006801:Humans; D008297:Male; D008875:Middle Aged; D060052:Nasolabial Fold / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult