title: Free groin flap in hemifacial volume reconstruction.
abstract: Use of the free groin flap, one of the first microvascular free flaps described, has been neglected recently because it has a short pedicle and varies anatomically. However, we have found its anatomical features and type of tissue ideal for volumetric enhancement in severe hemifacial asymmetry. We present a retrospective review of a consecutive series of 14 patients who had hemifacial augmentation with a free groin flap (mean age at operation 17 years, range 10-42) since 2001, and discuss the surgical technique. The most common cause of asymmetry was hemifacial microsomia (n=6). Anatomical variation of the vessels in the groin did not cause problems. Arterial anastomosis was to the facial artery in 13 patients; 12 patients had simultaneous hard tissue procedures. No flaps failed. The free groin flap is a useful adjunct in the management of hemifacial deficits in volume when free fat grafts will not provide enough bulk. Although the operation can take longer than non-vascularised grafts, little tissue is lost so long-term results may be more predictable. We have found the anatomy fairly consistent and the short pedicle caused no problems.
authors.affiliation: Craniofacial Unit, Great Ormond Street Hospital for Children, London, UK. alicobb@yahoo.com
authors.forename: Alistair R M
authors.initials: AR
authors.lastname: Cobb
authors.forename: Maarten J
authors.initials: MJ
authors.lastname: Koudstaal
authors.forename: Neil W
authors.initials: NW
authors.lastname: Bulstrode
authors.forename: Timothy W
authors.initials: TW
authors.lastname: Lloyd
authors.forename: David J
authors.initials: DJ
authors.lastname: Dunaway
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation; D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D063405:Anatomic Variation; D001158:Arteries / Q000601:surgery; D016025:Bone Transplantation / Q000379:methods; D002648:Child; D005145:Face / Q000098:blood supply; D005146:Facial Asymmetry / Q000601:surgery*; D005150:Facial Hemiatrophy / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000098:blood supply; D063172:Genioplasty / Q000379:methods; D006085:Graft Survival; D006119:Groin / Q000601:surgery; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods; D010027:Osteotomy / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D060053:Transplant Donor Site / Q000601:surgery; D055815:Young Adult