Palermo, Italy From the Cattedra di Chirurgia Plastica e Ricostruttiva, Dipartimento di Discipline Chirurgiche ed Oncologiche, Università di Palermo, and Plastic Surgery, University of Basel.
Plast Reconstr Surg. 2011 May;127(5):2068-2075. doi: 10.1097/PRS.0b013e31820e92a0.
Reconstruction of large defects in the temporal region can be performed with skin grafts or pedicled or free flaps. Results are often not optimal because of the patch of a skin graft, lack of availability of local flaps, and distant skin from free flaps. A technique for reconstruction of these defects with local tissue is presented in this article that uses superficial musculoaponeurotic system (SMAS) plication to allow wide advancement of a cervicofacial flap.
Once the defect is outlined, a face-lift-like skin incision is used to raise the flap. The SMAS is plicated with two purse-string sutures that relieve tension on the flap and allow maximal advancement. Thirteen face-lift SMAS plication flaps were used in 12 patients (mean age, 70.2 years) after cancer resection, which was bilateral in one case. Defects up to 8 cm in largest diameter can be closed. In one case of an 8 × 6-cm defect, a 1 × 1.5-cm skin graft was necessary.
All flaps healed uneventfully, and no reoperation was necessary. Scars are almost completely hidden and the cosmetic result is satisfactory. The asymmetrical face-lift effect fades out within 6 months.
The face-lift SMAS plication (FLISP) flap allows reconstruction of large defects in the temporal region with a local flap providing an excellent cosmetic result and avoiding the need for distant tissue and multiple scarring. This flap provides an example of how reconstructive surgery and cosmetic surgery are complementary and can be mutually beneficial.
颞部的大缺损可以通过皮片移植、带蒂或游离皮瓣来修复。由于皮片的补丁、局部皮瓣的不可用以及游离皮瓣的远距离皮肤，结果往往不理想。本文介绍了一种使用局部组织修复这些缺损的技术，该技术使用浅表肌肉筋膜系统（SMAS）折叠来允许广泛推进颈面部皮瓣。
一旦确定缺损范围，就会使用类似于面部提升的皮肤切口来提起皮瓣。通过两个荷包缝线来折叠 SMAS，以减轻皮瓣的张力并允许最大程度的推进。在 12 例癌症切除术后（平均年龄 70.2 岁）使用了 13 个面部提升 SMAS 折叠皮瓣，其中 1 例为双侧。最大直径达 8cm 的缺损可以闭合。在 1 例 8×6cm 的缺损中，需要进行 1×1.5cm 的皮片移植。
所有皮瓣均愈合良好，无需再次手术。疤痕几乎完全隐藏，美容效果满意。不对称的面部提升效果在 6 个月内消失。
面部提升 SMAS 折叠（FLISP）皮瓣可使用局部皮瓣重建颞部的大缺损，提供出色的美容效果，并避免需要远距离组织和多个疤痕。该皮瓣提供了一个例子，说明重建手术和美容手术是互补的，可以相互受益。
