title: Long-term outcome of the cheek advancement flap, a report of 41 cases.
abstract: BACKGROUND
  Due to incidental occurrence of ectropion as a late complication of cheek advancement flaps, this study investigated the long-term effects of these flaps for post-Mohs' reconstruction of the cheek aesthetic.
  
  
  METHODS
  All the patients who underwent a cheek advancement flap in the Catharina Hospital Eindhoven between January 2006 and January 2013 where included and assessed by means of a retrospective chart review and a survey about the long-term outcome and patient satisfaction.
  
  
  RESULTS
  A retrospective chart review was performed on all 54 eligible patients, and 41 (76%) of these patients participated in the study. The mean follow-up was 3.5 years (SD = 2.0, range = 1-7 years). Early complications were ectropion (6%), infection (2%), dog-ears (1%), haematoma (4%), and distal tip necrosis (2%). Late outcome and complications were sensory neuropathies (41%), late ectropion (7%), hypopigmentation of scars (29%), contractures (27%), and abnormal hair distribution (17%). Patients rated their reconstruction as good or excellent in 87% of cases.
  
  
  CONCLUSIONS
  The cheek advancement flap is a suitable technique for reconstruction of large cheek skin defects after excision of skin malignancies. However, patients should be informed that long-term complications, including ectropion, can occur. Additional follow-up might lead to an early detection of these late effects.
authors.affiliation: a The Department of Plastic and Reconstructive Surgery , Maastricht University Medical Center , Maastricht , The Netherlands.
authors.forename: Martijn A
authors.initials: MA
authors.lastname: van Onna
authors.affiliation: b The Department of Plastic and Reconstructive Surgery , Catharina Hospital , Eindhoven , The Netherlands.
authors.forename: Mona
authors.initials: M
authors.lastname: Haj
authors.affiliation: b The Department of Plastic and Reconstructive Surgery , Catharina Hospital , Eindhoven , The Netherlands.
authors.forename: Jeroen M
authors.initials: JM
authors.lastname: Smit
authors.affiliation: b The Department of Plastic and Reconstructive Surgery , Catharina Hospital , Eindhoven , The Netherlands.
authors.forename: Maarten M
authors.initials: MM
authors.lastname: Hoogbergen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002610:Cheek / Q000601:surgery*; D003286:Contracture / Q000209:etiology; D004483:Ectropion / Q000209:etiology; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017496:Hypopigmentation / Q000209:etiology; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery; D017060:Patient Satisfaction; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D012678:Sensation Disorders / Q000209:etiology; D012878:Skin Neoplasms / Q000601:surgery; D013524:Surgical Flaps
keywords: Mohs; cheek; cheek advancement; ectropion; neuropathies; outcome; reconstruction