title: Bipedicled Preexpanded Forehead Flaps for Simultaneous Reconstruction of Total Nasal and Upper Lip Subunits: A Novel Approach to Complex Facial Resurfacing.
abstract: Background Reconstruction of the central facial subunits is a complex and challenging task. In cases in which both the nasal and upper lip subunits are involved, a technique that can reconstruct both aesthetic units with tissue of similar color and texture from a single donor site will be ideal. In this article we present our experience with the bipedicled preexpanded forehead flap for simultaneous nasal and upper lip resurfacing. Patients and Methods Between January 2012 and January 2015 we used this technique in the simultaneous reconstruction of total nasal and upper lip subunits in five patients. All cases were for burns scar resurfacing. Results Good aesthetic results were achieved in each of our five cases to date and no complications were encountered. All donor sites closed primarily with aesthetically pleasing well-concealed linear scars. In all cases small modifications such as philtral shaping and further flap thinning were performed under local anesthesia between 6 and 12 months postoperatively Conclusion The preexpanded forehead flap provides an unparalleled color and texture match when it comes to facial resurfacing. When both total nasal and upper lip resurfacings are required, it is possible to achieve this in a single sitting from a single donor site by using a bipedicled preexpanded forehead flap.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
authors.forename: Weijie
authors.initials: W
authors.lastname: Su
authors.affiliation: Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
authors.forename: Peiru
authors.initials: P
authors.lastname: Min
authors.affiliation: Department of Plastic and Reconstructive Surgery, The Royal London Hospital, London, United Kingdom.
authors.forename: Parviz
authors.initials: P
authors.lastname: Sadigh
authors.affiliation: Department of Plastic and Reconstructive Surgery, Marche Polytechnic University Medical School, University Hospital of Ancona, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Grassetti
authors.affiliation: Plastic Reconstructive and Aesthetic Surgery Unit, Villa Salaria Clinic, Rome, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Lazzeri
authors.affiliation: Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
authors.forename: Krishna
authors.initials: K
authors.lastname: Munnee
authors.affiliation: Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
authors.forename: Zheming
authors.initials: Z
authors.lastname: Pu
authors.affiliation: Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
authors.forename: Yixin
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D002056:Burns / Q000473:pathology / Q000601:surgery; D002921:Cicatrix / Q000473:pathology / Q000601:surgery; D004954:Esthetics; D005151:Facial Injuries / Q000473:pathology / Q000601:surgery*; D005260:Female; D005546:Forehead / Q000601:surgery*; D006801:Humans; D008046:Lip / Q000293:injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009666:Nose / Q000293:injuries / Q000601:surgery*; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps; D016896:Treatment Outcome; D055815:Young Adult