title: Reconstructing facial contour deformities using stereoscopic thoracodorsal artery perforator adipofascial flaps.
abstract: OBJECTIVE
  Correcting facial contour deformities is a challenge, as it demands thoughtful planning on design, composition of flap, and secondary procedures. The thoracodorsal artery perforator (TDAP) flap has become a workhorse flap for various reconstructions. In this report, we present our experience of reconstructing facial contour deformities using the free TDAP adipofascial flap, focusing on its customized design.
  
  
  METHODS
  Sixteen patients underwent correction of a facial contour deformity with free TDAP adipofascial flaps from 2002 to 2012. The causes of defects were Romberg disease (n = 7), oncological defects (n = 5), craniofacial microsomia (n = 3), and trauma (n = 1). The flaps were three-dimensionally designed in a contour map fashion to have different thickness according to the defects by adjusting the height of adipose tissue and varying tissue composition. Customized dimension of flaps having reliable perfusion were harvested with minimized sacrifice of overlying skin.
  
  
  RESULTS
  Flap size ranged from 6 × 3 cm to 25 × 25 cm. Six flaps were based on two perforators and the other 10 on one. Five flaps were harvested in a chimeric fashion. All flaps survived completely. No donor morbidity developed in any case. Seven patients underwent secondary corrections including fat injection or liposuction. Improved contour and symmetry were achieved in all patients and was confirmed by a photographic evaluation. Mean follow-up period was 37.8months.
  
  
  CONCLUSIONS
  Our results suggest that the stereoscopic TDAP adipofascial flaps with diligent secondary approaches may be a reliable alternative for aesthetic reconstruction of facial contour deformities. © 2015 Wiley Periodicals, Inc. Microsurgery 37:300-306, 2017.
authors.affiliation: Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Eun-Ji
authors.initials: EJ
authors.lastname: Kim
authors.affiliation: Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Kyeong-Tae
authors.initials: KT
authors.lastname: Lee
authors.affiliation: Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: So-Young
authors.initials: SY
authors.lastname: Lim
authors.affiliation: Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Jai-Kyung
authors.initials: JK
authors.lastname: Pyon
authors.affiliation: Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Sa-Ik
authors.initials: SI
authors.lastname: Bang
authors.affiliation: Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Kap Sung
authors.initials: KS
authors.lastname: Oh
authors.affiliation: Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Goo-Hyun
authors.initials: GH
authors.lastname: Mun
mesh_terms: D000273:Adipose Tissue / Q000601:surgery / Q000637:transplantation; D000293:Adolescent; D000328:Adult; D002648:Child; D015331:Cohort Studies; D019465:Craniofacial Abnormalities / Q000601:surgery; D004954:Esthetics; D005151:Facial Injuries / Q000601:surgery; D005153:Facial Neoplasms / Q000601:surgery; D005205:Fascia / Q000637:transplantation; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D061525:Perforator Flap / Q000098:blood supply* / Q000637:transplantation*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013895:Thoracic Arteries / Q000601:surgery / Q000637:transplantation*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*; D055815:Young Adult