Adipofascial perforator flaps for "aesthetic" head and neck reconstruction.

BACKGROUND: Most head and neck reconstructions are performed for wound closure or functional rehabilitation with aesthetic restoration being an important but secondary consideration.

METHODS: Contour deformities in 40 patients undergoing head and neck resections were reconstructed immediately with adipofascial perforator flaps, including 37 anterolateral thigh and 3 deep inferior epigastric perforator flaps.

RESULTS: Reconstructions could be grouped into 1 of 3 defect areas: temporal fossa (n = 3), malar cheek (n = 13), and parotid-mastoid (n = 24). The mean time needed for reconstruction in excess of the oncologic resection was 3.1 hours. There were no flap losses. In no case did a complication delay adjuvant therapy and no patient experienced a decrease in level of activity related to donor site morbidity.

CONCLUSION: Immediate restoration of facial contour with adipofascial perforator flaps is warranted in head and neck oncologic patients to help improve self-image and maintain quality of life.