McAllister Lauren, Thornton James F
Department of Plastic and Reconstructive Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.
Semin Plast Surg. 2024 Nov 4;38(4):321-325. doi: 10.1055/s-0044-1791223. eCollection 2024 Nov.
The native features of the cheek allow for a variety of approaches when considering reconstruction following Mohs surgery. Selecting the best approach requires consideration of deficit size and location, skin laxity, surrounding anatomy, aesthetic outcomes, and specific patient factors. Reconstruction options vary based on the zone of the cheek affected, but direct closure remains the gold standard. When direct closure is not suitable, the use of the cervicofacial advancement flap, biologic agents, or a combination of the two should adequately address the majority of cheek deficits resulting from Mohs surgery. During cheek reconstruction, great care should be taken to maintain and support the surrounding anatomy, most notably the lower eyelid. Postoperative management is mostly comprised of scar management, as immediate, urgent complications are rare. Options to address postoperative scarring range from silicone sheeting to revisional surgery, but most deficits will settle well if given adequate time and are properly cared for with noninvasive measures.
在考虑Mohs手术（显微外科手术）后的重建时，脸颊的天然特征允许采用多种方法。选择最佳方法需要考虑缺损的大小和位置、皮肤松弛度、周围解剖结构、美学效果以及特定的患者因素。重建方案因脸颊受影响的区域而异，但直接缝合仍然是金标准。当直接缝合不合适时，使用颈面部推进皮瓣、生物制剂或两者结合应能充分解决Mohs手术导致的大多数脸颊缺损。在脸颊重建过程中，应格外小心以维持和支撑周围的解剖结构，最值得注意的是下眼睑。术后管理主要包括瘢痕管理，因为即刻、紧急并发症很少见。处理术后瘢痕的选择范围从硅胶片到修复手术，但如果给予足够的时间并采用非侵入性措施妥善护理，大多数缺损会恢复得很好。
