Salvage of Silicone-Treated Facial Deformities Using Autogenous Free Tissue Transfer

Abstract

We recommend the following surgical treatment guidelines for this unique subset of patients: silicone excision with immediate microvascular free flap reconstructive procedure when the skin and soft tissue are mildly to moderately affected, or silicone excision with delayed reconstructive procedure when the skin and soft tissue are severely affected. Free tissue transfer is a useful surgical tool for salvaging severe facial skin and soft-tissue deformities caused by previous silicone treatment.

Aesthetic Restoration of Parotidectomy Contour Deformity Using the Supraclavicular Artery Island Flap

“…Nonautologous injectables such as silicone can cause significant facial contour deformities that may require significant surgical revisions. 26 When patients are informed that delayed autologous fat grafting can be performed but is not covered by medical insurance, patients usually opt for immediate reconstruction.…”

Adipofascial perforator flaps for “aesthetic” head and neck reconstruction

“…Several authors have recommended microvascular free tissue transfer as a reliable technique for correcting congenital abnormalities resulting in contour deformities, such as hemifacial atrophy in Romberg's disease. [6][7][8][9] However, whereas soft tissue restoration with free flaps is commonplace in postoncologic breast reconstruction, reports of routine use of free flaps for contour deformities after head and neck resections are rare. 10 There has traditionally been hesitation to use immediate microvascular reconstruction of contour deformities in head and neck cancer cases in which primary closure of the wound could be achieved without a free flap due to concerns of increased operative time, increased complication rates that may delay adjuvant therapy, donor site morbidity, and concern for soft tissue masking a local recurrence.…”

Correction of Hemifacial Atrophy With Autologous Fat Transplantation

“…7 Severe soft-tissue complications of the face resulted from silicone treatment of facial contour. 10 Although microvascular free tissue transfer has revolutionized the surgical treatment of severe hemifacial atrophy, it also inherits several problems such as donor-site scar and morbidity, a lengthy operation and higher cost to patients, and possibility of total flap loss. In addition, microvascular free flaps can be bulky, have a tendency to sag due to gravity, and often require subsequent procedures for thinning and resuspension.…”