Anterolateral thigh adipofascial flap for the restoration of facial contour deformities

Abstract

From January 2000 to May 2008, 50 patients with facial contour deformities underwent soft tissue augmentation with 51 anterolateral thigh (ALT) adipofascial flaps. Fifty flaps survived with no complications; partial fat necrosis occurred in one flap. Mean follow-up was 16 months. Flaps ranged from 10 x 6 cm to 20 x 12 cm. Perforators were found in 50 flaps, 43 musculocutaneous perforators (84.3%) and 7 septocutaneous perforators (13.7%), with a mean of 2.5 perforators per flap. In one flap (2.0%), no perforator was found. In this case, we used an anteromedial thigh adipofascial flap using the medial branch of the descending branch of lateral circumflex femoral artery as the vascular pedicle. Relatively symmetric facial contour was achieved in 20 cases. In 30 cases, adjunctive procedures including flap debulking, fat injection, and resuspension were necessary, and 23 patients achieved satisfactory outcomes. We conclude that the ALT adipofascial flap can be successfully elevated and transplanted for the correction of soft tissue facial defects. This flap can provide tissue to fill large defects, and posses the qualities of pliability, an excellent blood supply, ease of suspension and fixation, and minimal morbidity at the donor site.

Salvage Free Anterolateral Thigh Composite Flap Transfer Based on the Musculocutaneous Perforator Retrograde Blood Flow Principle

“…[5][6][7][8][9][10][11][12] We have previously reported one of the largest studies with the use of anterolateral thigh adipofascial flap for the restoration of facial contour deformities. 2 The robustness and versatility of the ALT flap is further demonstrated in this article when the ipsilateral STA was not suitable for microanastomosis. The ALT flap was successfully salvaged with a myo-adipofascial ALT flap based on retrograde blood flow principle (Fig.…”

“…2 Handheld Doppler and computed tomographic angiography (CTA) were performed to detect both the donor and recipient vessels preoperatively. Two perforators of the donor site were located at a line between the anterior superior iliac spine and the superolateral aspect of the patella.…”

Dental management of patients with microstomia. A review of the literature and update on the treatment.

“…Triangular flaps with pedicles have been used for commissuroplasty, in the form of Z-plasty at the level of the internal mucosa or rhomboid flaps 12,36 . Transposition of the orbicularis muscle along with an advance of the oral mucosa or free grafts from thigh or forearm have been used to rebuild the edge of the lip flaps 37 . Flaps with oblique incision of vermilion to transpose them or bring them closer to the new oral commissure 37 of extending the oral aperture to make it functional and aesthetically acceptable without recurrence.…”

“…Transposition of the orbicularis muscle along with an advance of the oral mucosa or free grafts from thigh or forearm have been used to rebuild the edge of the lip flaps 37 . Flaps with oblique incision of vermilion to transpose them or bring them closer to the new oral commissure 37 of extending the oral aperture to make it functional and aesthetically acceptable without recurrence. This technique is simpler and cheaper when compared to traditional surgical methods that are generally more expensive, complex, and less practical 38 .…”

Simultaneous Anterolateral Thigh Flap and Temporalis Tendon Transfer to Optimize Facial Form and Function After Radical Parotidectomy

“…Given its ability to impart accurate and lasting volume correction (even with radiotherapy), vascularized free tissue transfer is becoming the criterion standard for postparotidectomy defect reconstruction, regardless of facial nerve involvement. 5,6 In particular, the anterolateral thigh (ALT) flap provides an ideal soft-tissue flap because of its component versatility, straightforward harvest, low donor site morbidity, and access to redundant motor nerves suitable for grafting.…”