title: Perforator-supercharged occipitocervicopectoral flaps for lower face and neck reconstruction.
abstract: BACKGROUND
  The occipitocervicopectoral flap has a local skin pedicle in the occipital region, with the distal portion of the flap in the pectoral region. One disadvantage of the occipitocervicopectoral flap is its limited flap length. To overcome this disadvantage, a perforator supercharging technique was applied to enlarge the original flap length. The aims of this study are to present a clinical application of the perforator-supercharged occipitocervicopectoral flap for face and neck reconstruction and to discuss a perforator supercharging technique and perforator anatomy.
  
  
  METHODS
  All perforator-supercharged occipitocervicopectoral flaps that were used for face and neck reconstructions were analyzed retrospectively.
  
  
  RESULTS
  In all nine cases, the second internal mammary artery perforator was attached at the end of the occipitocervicopectoral flap and supercharged with the contralateral recipient facial artery vessels. The average flap size was 22.6 × 6.2 cm, without any flap loss. It was possible to cover a large defect extending to bilateral sides with thin and pliable local skin tissue. All patients were satisfied with functional and aesthetic results achieved postoperatively after 6 months.
  
  
  CONCLUSIONS
  The internal mammary artery perforator-supercharged occipitocervicopectoral flap can be considered a type of bipedicle perforator flap and can provide reliable flap vascularity. By using a perforator supercharging technique, we can adjust and enlarge the flap length tailored to the defect.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Tokyo, Japan; Ann Arbor, Mich.; and Guangzhou, People's Republic of China From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Nippon Medical School; the Section of Plastic Surgery, Department of Surgery, University of Michigan Health System; and the Department of Plastic and Reconstructive Surgery, Nanfang Medical University.
authors.forename: Shimpei
authors.initials: S
authors.lastname: Ono
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Chung
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Takami
authors.forename: Takafumi
authors.initials: T
authors.lastname: Chin
authors.forename: Rei
authors.initials: R
authors.lastname: Ogawa
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Gao
authors.forename: Hiko
authors.initials: H
authors.lastname: Hyakusoku
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002056:Burns / Q000150:complications; D002648:Child; D003286:Contracture / Q000209:etiology / Q000601:surgery; D005145:Face / Q000601:surgery*; D005151:Facial Injuries / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000637:transplantation; D008875:Middle Aged; D009333:Neck / Q000601:surgery*; D019838:Neck Injuries / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods; D013524:Surgical Flaps / Q000098:blood supply*; D020858:Tissue and Organ Harvesting / Q000379:methods; D055815:Young Adult