title: Reconstruction of Skin Defects on the Mid and Lower Face Using Expanded Flap in the Neck.
abstract: BACKGROUND
  The reconstruction of major burn and other deformities resulting from significant soft tissue deficits of the face is a continuing challenge for surgeons. In the study, the authors introduce our 5-year experiences using expanded flap in the neck for reconstruction on the mid and lower face.
  
  
  METHODS
  From 2008 and 2013, 12 tissue expanders were used in 12 patients for face resurfacing. The operation consisted of 2 steps. In the first step, the expander was placed subcutaneously under the skin of the neck and they were expanded timely to create adequate superfluous skin and soft tissue. In the second step, the expanded flap was transferred to reconstruct the defects on the mid and lower face after excision of the lesions.
  
  
  RESULTS
  All 12 patients with lesions on the mid and lower face underwent successful facial resurfacing with the described technique in the last 5 years. The follow-up ranged from 6 to 24 months. Flaps did not shrink after the operations, and subsequent contractures did not recur. The cervicomental angle appeared normal. All flaps survived well except 2 patients developed slight necrosis at the distal edge and no other major complication was observed. Esthetic outcomes were rated to be very good in 10 patients (83.3%) and good in 2 patients (16.7%).
  
  
  CONCLUSIONS
  The application of expanded flaps in the neck is proved to be an effective way of repairing facial defects on the mid and lower face. The technique is remarkably reliable in resurfacing the peripheral facial esthetic units.
authors.affiliation: Plastic Surgery Department, China Japan Friendship Hospital, Beijing, China.
authors.forename: Xiaogen
authors.initials: X
authors.lastname: Hu
authors.forename: Gao
authors.initials: G
authors.lastname: Zeng
authors.forename: Yang
authors.initials: Y
authors.lastname: Zhou
authors.forename: Cheng
authors.initials: C
authors.lastname: Sun
mesh_terms: D000293:Adolescent; D000328:Adult; D002056:Burns / Q000601:surgery; D002648:Child; D003286:Contracture / Q000209:etiology; D004954:Esthetics; D005151:Facial Injuries / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D009333:Neck / Q000601:surgery; D009336:Necrosis / Q000209:etiology; D012867:Skin / Q000473:pathology; D016038:Skin Transplantation / Q000009:adverse effects; D013524:Surgical Flaps / Q000009:adverse effects; D015626:Tissue Expansion / Q000379:methods*; D055815:Young Adult