title: One-stage transfer of 2 paddles of thoracodorsal artery perforator flap with 1 pair of vascular anastomoses for Barraquer-Simons syndrome.
abstract: We report a novel technique: a 1-stage transfer of 2 paddles of thoracodorsal artery perforator (TAP) flap with 1 pair of vascular anastomoses for simultaneous restoration of bilateral facial atrophy. A 47-year-old woman with a severe bilateral lipodystrophy of the face (Barraquer-Simons syndrome) was surgically treated using this procedure. Sufficient blood supply to each of the 2 flaps was confirmed with fluorescent angiography using the red-excited indocyanine green method. A good appearance was obtained, and the patient was satisfied with the result. Our procedure has advantages over conventional methods in that bilateral facial atrophy can be augmented simultaneously with only 1 donor site. Furthermore, our procedure requires only 1 pair of vascular anastomoses and the horizontal branch of the thoracodorsal nerve can be spared. To our knowledge, this procedure has not been reported to date. We consider that 2 paddles of TAP flap are safely elevated if the distal flap is designed on the descending branch, and this technique is useful for the reconstruction of bilateral facial atrophy or deformity.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan. okazaki-m@umin.ac.jp
authors.forename: Mutsumi
authors.initials: M
authors.lastname: Okazaki
authors.forename: Kentaro
authors.initials: K
authors.lastname: Tanaka
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kodaira
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Homma
authors.forename: Hiroki
authors.initials: H
authors.lastname: Miyashita
mesh_terms: D000714:Anastomosis, Surgical; D001284:Atrophy; D005145:Face / Q000601:surgery*; D005260:Female; D006801:Humans; D008060:Lipodystrophy / Q000601:surgery*; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply*