Reconstruction of facial defects and deformities using neck and chest flaps

Objective. To develop methods for obtaining enlarged flaps with their own vessels in the cervicothoracic region for the reconstruction of defects and deformities of the lower and middle parts of the face. Materials and methods. The results of treatment of 16 patients with facial defects and deformities were analysed. Nineteen flaps were used in the cervicothoracic region: lateral neck skin and muscle flaps with subcutaneous muscle (5), supraclavicular flaps (4), bilobed lateral neck skin and muscle flaps with supraclavicular flaps (6), and bilobed cervicothoracic flaps with supraclavicular flaps (4). Balloon expansion of 14 flaps was used to increase the amount of plastic material. Results. Complete engraftment of 13 (68.4% ± 2.3%) flaps was obtained, in 3 observations it was not possible to completely remove the scars, in 2 observations inflammation and sutures occurred, and in 1 observation necrosis of 20% of the cervical flap area occurred. Conclusions. The most promising for plastic surgery of facial defects and deformities are cervicothoracic, supraclavicular and lateral neck skin and muscle flaps. Using skin expansion methods, the amount of plastic material can be increased.