Byun Il Hwan, Byun Dahn, Baek Woo Yeol
Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea.
Eulji University College of Medicine, Daejeon, Korea.
Arch Craniofac Surg. 2016 Dec;17(4):240-243. doi: 10.7181/acfs.2016.17.4.240. Epub 2016 Dec 23.
Perfect facial and body symmetry is an important aesthetic concept which is very difficult, if not impossible, to achieve. Yet, facial asymmetries are commonly encountered by plastic and reconstructive surgeons. Here, we present a case of posttraumatic facial asymmetry successfully treated with a unique concept of facial flap repositioning. A 25-year-old male patient visited our department with severe posttraumatic facial asymmetry. There was deviated nasal bone and implant to the right, and the actual facial appearance asymmetry was much more severe compared to the computed tomography, generally shifted to the right. After corrective rhinoplasty, we approached through intraoral incision, and much adhesion from previous surgeries was noted. We meticulously elevated the facial flap of both sides, mainly involving the cheeks. The elevated facial flap was shifted to the left, and after finding the appropriate location, we sutured the middle portion of the flap to the periosteum of anterior nasal spine for fixation. We successfully freed the deviated facial tissues and repositioned it to improve symmetry in a single stage operation. We conclude that facial flap repositioning is an effective technique for patients with multiple operation history, and such method can successfully apply to other body parts with decreased tissue laxity.
完美的面部和身体对称是一个重要的美学概念，即便并非完全不可能实现，也是非常困难的。然而，整形和重建外科医生经常会遇到面部不对称的情况。在此，我们展示一例通过独特的面部皮瓣重新定位概念成功治疗的创伤后面部不对称病例。一名25岁男性患者因严重的创伤后面部不对称前来我科就诊。鼻骨向右偏斜且有植入物，实际面部外观不对称比计算机断层扫描显示的更为严重，整体向右偏移。在进行矫正鼻整形术后，我们通过口内切口入路，发现有大量来自既往手术的粘连。我们精心掀起双侧面部皮瓣，主要涉及脸颊。将掀起的面部皮瓣向左移位，找到合适位置后，将皮瓣中间部分缝合至前鼻棘骨膜进行固定。我们在一期手术中成功松解了偏斜的面部组织并重新定位，以改善对称性。我们得出结论，面部皮瓣重新定位对于有多次手术史的患者是一种有效的技术，并且这种方法可以成功应用于其他组织松弛度降低的身体部位。
