title: Reconstruction of the face and neck with different types of pre-expanded anterior chest flaps: a comprehensive strategy for multiple techniques.
abstract: BACKGROUND
  For large defects or deformities of the face and neck, the anterior chest area appears to be an excellent donor site that provides well-matched skin colour and texture. Many flap techniques based on the anterior chest area have been reported; however, there are few reports that focus on a treatment strategy for these different flap techniques.
  
  
  METHODS
  A retrospective study was performed to propose a treatment algorithm. A total of 69 cases were reviewed from May 2005 to July 2011, in which different types of anterior chest flaps were performed for face and neck reconstruction. The reconstructive procedures, the defect characteristics and the complications were collected and analysed.
  
  
  RESULTS
  Thirty-three pedicled thoracic branch of the supraclavicular artery flaps (the pedicled TBSA flap), 11 pedicled internal mammary artery perforator flaps (the pedicled IMAP flap), 8 free internal mammary artery perforator flaps (the free IMAP flap), 4 supercharged TBSA flaps, 17 prefabricated flaps and 3 supercharged prefabricated flaps were performed. The applications of six types of pre-expanded anterior chest flaps were described in an algorithmic approach.
  
  
  CONCLUSIONS
  A treatment strategy for face and neck reconstruction using six anterior chest flap techniques is proposed. It recommended a personalised flap planning according to the characteristics of deformities/defects and the regionally dominant vessels of the anterior chest area.
authors.affiliation: Department of Plastic and Reconstructive Surgery, The Ninth Hospital, Medical School of Shanghai Jiao tong University, Shanghai 200011, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Zan
authors.forename: Haizhou
authors.initials: H
authors.lastname: Li
authors.forename: Zijing
authors.initials: Z
authors.lastname: Du
authors.forename: Bin
authors.initials: B
authors.lastname: Gu
authors.forename: Kai
authors.initials: K
authors.lastname: Liu
authors.forename: Feng
authors.initials: F
authors.lastname: Xie
authors.forename: Yun
authors.initials: Y
authors.lastname: Xie
authors.forename: QingFeng
authors.initials: Q
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D044964:Cervicoplasty / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005145:Face / Q000601:surgery*; D005260:Female; D058752:Free Tissue Flaps; D006801:Humans; D008297:Male; D008323:Mammary Arteries; D008875:Middle Aged; D061525:Perforator Flap / Q000098:blood supply; D012189:Retrospective Studies; D035441:Thoracic Wall / Q000601:surgery; D015626:Tissue Expansion; D055815:Young Adult
keywords: Face and neck reconstruction; Perforator flap; Prefabricated flap; Surgical flap; Tissue expansion