The single dominant medial row perforator has a maximal vascularity in zones I and II, and less in zones III an IV. The authors recommend that half of zone III and all of zone IV be discarded to avoid the risks of partial flap loss and fat necrosis.
Circumferential abdominoplasty and abdominoplasty performed in combination with an intraabdominal procedure were demonstrated to have significantly increased risk for venous thromboembolism. Patients undergoing these procedures should be risk stratified and have perioperative prophylaxis managed accordingly. It is suggested that both of these operations be placed into a higher exposing risk category within the modified Davison-Caprini risk assessment model.
In summary, the advantages of the FAMM flap closure technique were (1) no visible external scar, with minimal donor site morbidity; (2) successful closure of large septal defects (>2 cm) with vascularized tissue in a single stage; and (3) resolution of patient symptomatology.
The lower lateral crural turnover flap is a useful and reproducible technique in rhinoplasty with enduring results. The use of adjacent cartilage provides a local source of viable tissue to correct and support the lower lateral crura in both primary and revision rhinoplasty.
The dimensions of a TMG flap can be increased horizontally (superoposterior thigh) as well as vertically. The vertical portion can be harvested either by undermining the skin inferior to the lower transverse skin incision or by raising a trilobed skin paddle to harvest even more tissue from the medial thigh.
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