title: Design of a modified monobloc composite facial allograft technique in facial reconstruction.
abstract: BACKGROUND
  Composite facial allografts have become increasingly popular in the reconstruction of complex facial defects. Good to excellent aesthetic results can be achieved, particularly when a foundation of donor skeleton has been transferred. The authors propose using a conventional craniofacial technique (monobloc osteotomy) to transfer a thin monocortical foundation of bone, even in lieu of a skeletal defect, to improve the recipient periorbital and malar aesthetics.
  
  
  METHODS
  The monobloc osteotomy approach was used to obtain a full facial allograft and modified ex vivo to a thin monocortical layer and transferred to an anatomical facial skeleton. The authors have named this the "masque" flap because of the resemblance of the outline of the foundation of bone to a costume worn in masquerade balls.
  
  
  RESULTS
  The masque flap was performed on two fresh-frozen cadavers. The total time to harvest and thin the osteomyocutaneous flap was 155 minutes (30 minutes to modify it ex vivo). The average total surface area was 1060 cm. Periorbital and malar ligaments were maintained, as was the integrity of the canthal tendons.
  
  
  CONCLUSIONS
  The modified monobloc composite facial allograft technique allows transfer of a full facial allograft and maintains malar projection and excellent shape of the palpebral aperture.
authors: Philadelphia, Pa. From the Hospital of the University of Pennsylvania.
authors: Nicholas
authors: N
authors: Bastidas
authors: Patrick
authors: P
authors: Gerety
authors: Jesse A
authors: JA
authors: Taylor
mesh_terms: D002102:Cadaver; D005145:Face / Q000601:surgery*; D054445:Facial Transplantation; D006801:Humans; D010027:Osteotomy / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps