Autogenous soft-tissue procedures and osseointegrated alloplastic reconstruction: their role in the treatment of complex craniofacial defects.

Between 1990 and 1994, twenty-seven patients with extraoral craniofacial defects were treated at the Craniofacial Osseointegration and Maxillofacial Prosthetic Rehabilitation Unit in Edmonton. Fourteen patients required management by a combination of alloplastic and autogenous techniques to optimize their reconstructive result. Autogenous soft-tissue procedures were performed almost twice as often in patients whose deformity was the result of trauma. Autogenous soft-tissue procedures included soft-tissue expansion, static facial slings, free and pedicled vascularized bone grafts, eyebrow reconstruction, brow lifts, and scar revisions. These reconstructive procedures are illustrated in three cases.