Tan Onder, Atik Bekir, Parmaksizoglu Duygu
Department of Plastic, Reconstructive, and Aesthetic Surgery, Ataturk University, Erzurum, Turkey.
Plast Reconstr Surg. 2007 Mar;119(3):873-9. doi: 10.1097/01.prs.0000252002.76466.cf.
Facial contour augmentation is an entity often encountered by reconstructive surgeons. To date, very different autologous tissues such as fat, dermofat, dermal fascia, muscle, cartilage, and bone in the manner of grafts or flaps according to the requirements of the defect have been used for facial augmentation. Although many free flap procedures have become popular in facial contouring, these microsurgical methods have some limitations and risks, especially in patients who are not suitable for microsurgery. Moreover, the patient may wish to be treated by means of a more conservative procedure.
The authors used the submental flap in deepithelialized fashion successfully for augmentation of the face in three patients who presented with hemifacial microsomia (n = 2) and longstanding facial paralysis (n = 1).
Adequate augmentation was achieved in all cases, without any complications. All donor sites were closed primarily and healed well. Patient satisfaction was perfect in all cases. A second debulking procedure was performed in case 3 only. The average follow-up was 1 year.
The authors believe that the deepithelialized submental flap can be used safely for all facial contour restorations of the lower and midface necessitated by various causes, including hemifacial microsomia and facial paralysis as a main or adjunct procedure. In these cases, this flap may be a good alternative, especially for patients who are not suitable for microsurgery.
面部轮廓增大是整形外科医生经常遇到的情况。迄今为止，根据缺损的要求，已采用了非常不同的自体组织，如脂肪、真皮脂肪、真皮筋膜、肌肉、软骨和骨，以移植或皮瓣的方式用于面部增大。尽管许多游离皮瓣手术在面部轮廓整形中已很流行，但这些显微外科方法有一些局限性和风险，尤其是在不适合显微手术的患者中。此外，患者可能希望通过更保守的手术进行治疗。
作者成功地将去上皮化的颏下皮瓣用于3例患者的面部增大，其中2例为半侧颜面短小畸形，1例为长期面瘫。
所有病例均获得了足够的增大效果，无任何并发症。所有供区均一期缝合，愈合良好。所有病例患者满意度均很高。仅第3例患者进行了二次减容手术。平均随访1年。
作者认为，去上皮化的颏下皮瓣可安全地用于因各种原因导致的面中下部所有面部轮廓修复，包括半侧颜面短小畸形和面瘫，作为主要或辅助手术。在这些情况下，该皮瓣可能是一个很好的选择，尤其是对于不适合显微手术的患者。
