title: Aesthetic Reconstruction of the Frontotemporal Region: The Extended A-T Plasty, A Workhorse Revisited.
abstract: BACKGROUND
  A-T plasty has long been a workhorse for defects located around the eyebrow or in the upper and lower lip. It allows like-with-like reconstruction with placement of the scars in natural creases or subunit junctions. In this article, the authors describe their refined technique to specifically address moderate to large size defects of the frontotemporal, preauricular, and zygomatic regions.
  
  
  METHODS
  Thirty consecutive patients underwent reconstruction with the extended A-T plasty at our institution after skin cancer excision. Mean age at surgery was 63 years (range, 39-87 years). Mean defect size was 5.2 × 4.7 cm. The defects were located in the frontotemporal (13), upper preauricular (10), and zygomatic (7) facial subunits.
  
  
  RESULTS
  Mean operative time was 65 minutes. Three (10%) patients suffered from delayed healing at the T junction, with no impairment in the long-term follow-up. All the other flaps healed uneventfully with optimal long-term cosmetic and functional restoration. Follow-up ranged from 3 months to 3 years (mean, 19 months).
  
  
  CONCLUSIONS
  The basic principles of the A-T plasty were applied to design large advancement-rotation flaps incorporating frontotemporal and preauricular cervicofacial skin. The resulting extended A-T plasty proved to be a simple, reliable, and reproducible technique to resurface, in a "like with like" fashion, moderate to large defects located in the frontotemporal, preauricular and zygomatic facial subunits.
authors.affiliation: From the Unit of Plastic Surgery and Dermatology, "Campus Bio-Medico di Roma" University, Rome, Italy.
authors.forename: Beniamino
authors.initials: B
authors.lastname: Brunetti
authors.forename: Stefania
authors.initials: S
authors.lastname: Tenna
authors.forename: Igor
authors.initials: I
authors.lastname: Poccia
authors.forename: Francesco
authors.initials: F
authors.lastname: Segreto
authors.forename: Paolo
authors.initials: P
authors.lastname: Persichetti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004954:Esthetics; D005153:Facial Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D005624:Frontal Bone; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply / Q000637:transplantation*; D013701:Temporal Bone; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology