title: Reconstruction of through-and-through cheek defects with folded free anterolateral thigh flaps.
abstract: OBJECTIVE
  The purpose of this study was to assess the clinical application and therapeutic efficacy of through-and-through cheek defects reconstructed with folded anterolateral thigh (ALT) flaps.
  
  
  METHODS
  From January 2009 to May 2012, 10 patients with through-and-through cheek defects resulting from resection of cheek tumor underwent reconstruction with the folded ALT flap at Sun Yat-Sen University Cancer Center, Guangzhou, China. Surgical procedures in harvesting the ALT flap, as well as the surgical anatomy, are described, and the success rate is reported.
  
  
  RESULTS
  All ALT flaps were fasciocutaneous flaps. One patient with a thrombotic event required operative exploration in the perioperative period. All 10 flaps were based on a single perforator for reconstruction of defects. In all 10 cases, the donor site was closed primarily for the ALT flap, leaving only a linear scar that was inconspicuous with normal clothing, and the thigh had no functional deficit.
  
  
  CONCLUSIONS
  The free ALT flap has good pliability and can be folded for the reconstruction of both the inner and outer lining of through-and-through cheek defects. This flap presents good functional results at the recipient site with the additional advantages of minimal donor-site morbidity, a very acceptable esthetic result, and a high level of patient satisfaction.
authors.affiliation: State Key Laboratory of Oncology in South China, Department of Head and Neck Surgery, Cancer Center, Sun Yat-Sen University, Guangzhou, China.
authors.forename: Zhi-Min
authors.initials: ZM
authors.lastname: Liu
authors.forename: Di
authors.initials: D
authors.lastname: Wu
authors.forename: Xue-Kui
authors.initials: XK
authors.lastname: Liu
authors.forename: Wei-Wei
authors.initials: WW
authors.lastname: Liu
authors.forename: Hao
authors.initials: H
authors.lastname: Li
authors.forename: Quan
authors.initials: Q
authors.lastname: Li
authors.forename: Xin-Rui
authors.initials: XR
authors.lastname: Zhang
authors.forename: Zong-Yuan
authors.initials: ZY
authors.lastname: Zeng
authors.forename: Zhu-Ming
authors.initials: ZM
authors.lastname: Guo
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D002610:Cheek / Q000601:surgery*; D004954:Esthetics; D005205:Fascia / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000637:transplantation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery; D009367:Neoplasm Staging; D017060:Patient Satisfaction; D061525:Perforator Flap / Q000473:pathology; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000379:methods*; D050151:Subcutaneous Fat / Q000601:surgery; D013848:Thigh / Q000601:surgery; D020858:Tissue and Organ Harvesting / Q000379:methods; D060053:Transplant Donor Site / Q000473:pathology; D016896:Treatment Outcome