The folded trapezius flap for through-and-through cheek defects.

A through-and-through defect of the cheek is a reconstructive challenge--functionally, technically, and cosmetically. The goal of reconstruction is to reliably and expediently bridge a poorly vascularized gap with healthy tissue. Since 1979, five patients have undergone folded trapezius flap reconstruction of the cheek. Despite a history of radiation in four of the five, all flaps have healed and complications have been minimal. The key to success seems to be careful attention to the venous drainage. This technique provides a one-stage reconstruction of a difficult surgical defect.