title: Expanded Cheek-Shaped Flap for Aesthetic Cheek Reconstruction in the Cervicoperiauricular Area.
abstract: BACKGROUND
  The cervical area is well acknowledged as an ideal donor site for aesthetic reconstruction of the cheek, and tissue expansion may play an important role for maximally achieving such a purpose. However, the conventional design of the expanded cervical flap generally results in unsightly morbidity of the donor site. The aim of this study is to evaluate the results of using an improvised cervical expanded flap in aesthetic reconstruction of the cheek.
  
  
  METHODS
  From July 2004 to October 2012, a total of 23 burn sequelae patients (30 cheeks) underwent cheek reconstruction with an expanded flap that originated from the cervicoperiauricular area. The procedures were initially carried out with the insertion of a round tissue expander in the cervicoperiauricular area, followed by serial inflation of the expander, and finally, transplantation of the expanded flap to the cheek in a rotation advancement fashion. The donor site closure was along the auricular sulcus.
  
  
  RESULTS
  The average area of the harvested flaps was 9.7 × 8.1 cm. All the flaps completely survived, only one major complication occur-a dome exposure of the tissue expander after the expansion was completed. The flap was salvaged, and the transfer stage was done without intact. Minor complications after flap transfer include: widened scar at the donor site, a "dog-ear" needing additional minor surgery, distal part of the flap transient congestion. The patients achieved very satisfactory results functionally and aesthetically.
  
  
  CONCLUSIONS
  Using the expanded cheek-shaped flap technique can provide a safe, thin, and color-matched flap in aesthetic reconstruction of the cheek with minimal donor site morbidity.
authors.affiliation: From the Ninth Department of Plastic Surgery, Plastic Surgery Hospital of Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Jia
authors.initials: J
authors.lastname: Tian
authors.forename: Jincai
authors.initials: J
authors.lastname: Fan
authors.forename: Liqiang
authors.initials: L
authors.lastname: Liu
authors.forename: Cheng
authors.initials: C
authors.lastname: Gan
authors.forename: Zengjie
authors.initials: Z
authors.lastname: Yang
authors.forename: Wenlin
authors.initials: W
authors.lastname: Chen
authors.forename: Zhuming
authors.initials: Z
authors.lastname: Yin
mesh_terms: D000293:Adolescent; D000328:Adult; D002056:Burns / Q000601:surgery*; D002610:Cheek / Q000293:injuries / Q000601:surgery*; D002648:Child; D054644:Ear Auricle / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009333:Neck / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods*; D013524:Surgical Flaps; D015626:Tissue Expansion / Q000295:instrumentation / Q000379:methods*; D015625:Tissue Expansion Devices; D055815:Young Adult