Download PDF
J Reconstr Microsurg 2011; 27(2): 079-082
DOI: 10.1055/s-0030-1267833
© Thieme Medical Publishers

A Minimally Invasive Technique for Burying Free Flaps and Grafts

Tristan L. Hartzell1 , Julian J. Pribaz1
  • 1Division of Plastic and Reconstructive Surgery, Brigham and Women's Hospital, Boston, Massachusetts
Further Information

Publication History

Publication Date:
13 October 2010 (online)

    Permissions and Reprints

ABSTRACT

The placement of large-volume flaps and grafts into a subcutaneous pocket often requires extensive incisions for accurate placement. We describe a technique that allows for the precise, atraumatic placement of these tissues through minimal incisions. No unusual or expensive surgical instrumentation is required, and the technique is easy to learn. We have found the technique especially useful in the augmentation of severe facial atrophy.

KEYWORDS

Techniques - facial atrophy - minimally invasive

REFERENCES

  • 1 Little J W. Three-dimensional rejuvenation of the midface: volumetric resculpture by malar imbrication.  Plast Reconstr Surg. 2000;  105 267-285 discussion 286-289
    CrossrefPubMedGoogle Scholar
  • 2 Hinderer U T. Malar implants for improvement of the facial appearance.  Plast Reconstr Surg. 1975;  56 157-165
    CrossrefPubMedGoogle Scholar
  • 3 May Jr J W, Zenn M R, Zingarelli P. Subciliary malar augmentation and cheek advancement: a 6-year study in 22 patients undergoing blepharoplasty.  Plast Reconstr Surg. 1995;  96 1553-1559
    CrossrefPubMedGoogle Scholar
  • 4 Edgerton M T, Wells J H. Indications for and pitfalls of soft tissue augmentation with liquid silicone.  Plast Reconstr Surg. 1976;  58(2) 157-165
    CrossrefPubMedGoogle Scholar
  • 5 Erol O O. Facial autologous soft-tissue contouring by adjunction of tissue cocktail injection (micrograft and minigraft mixture of dermis, fascia, and fat).  Plast Reconstr Surg. 2000;  106 1375-1387 discussion 1388-1389
    CrossrefPubMedGoogle Scholar
  • 6 Cortese A, Savastano G, Felicetta L. Free fat transplantation for facial tissue augmentation.  J Oral Maxillofac Surg. 2000;  58 164-169 discussion 169-170
    CrossrefPubMedGoogle Scholar
  • 7 Coleman J J, Jurkiewicz M J, Nahai F, Mathes J M. The platysma musculocutaneous flap: experience with 24 cases.  Plast Reconstr Surg. 1983;  72 315-323
    CrossrefPubMedGoogle Scholar
  • 8 Shintomi Y, Ohura T, Honda K, Iida K. The reconstruction of progressive facial hemi-atrophy by free vascularised dermis-fat flaps.  Br J Plast Surg. 1981;  34 398-409
    CrossrefPubMedGoogle Scholar
  • 9 Upton J, Mulliken J B, Hicks P D, Murray J E. Restoration of facial contour using free vascularized omental transfer.  Plast Reconstr Surg. 1980;  66 560-569
    CrossrefPubMedGoogle Scholar
  • 10 Leaf N, Zarem H A. Correction of contour defects of the face with dermal and dermal-fat grafts.  Arch Surg. 1972;  105 715-719
    PubMedGoogle Scholar
  • 11 Kazanjian V H, Sturgis S H. Surgical treatment of hemiatrophy of the face.  JAMA. 1940;  115 348-354
    PubMedGoogle Scholar
  • 12 Little J W. Applications of the classic dermal fat graft in primary and secondary facial rejuvenation.  Plast Reconstr Surg. 2002;  109 788-804
    Google Scholar
  • 13 Ho-Asjoe M, Khan J, Frame J D. Dermal grafting for a patient with scleroderma. Case report.  Scand J Plast Reconstr Surg Hand Surg. 1996;  30 325-327
    CrossrefPubMedGoogle Scholar
  • 14 McClinton M A. The use of dermal-fat grafts.  Hand Clin. 1996;  12 357-364
    PubMedGoogle Scholar
  • 15 Davis R E, Guida R A, Cook T A. Autologous free dermal fat graft. Reconstruction of facial contour defects.  Arch Otolaryngol Head Neck Surg. 1995;  121 95-100
    CrossrefPubMedGoogle Scholar
  • 16 Patel I A, Hall P N. Free dermis-fat graft to correct the whistle deformity in patients with cleft lip.  Br J Plast Surg. 2004;  57 160-164
    CrossrefPubMedGoogle Scholar
  • 17 Mordick II T G, Larossa D, Whitaker L. Soft-tissue reconstruction of the face: a comparison of dermal-fat grafting and vascularized tissue transfer.  Ann Plast Surg. 1992;  29 390-396
    CrossrefPubMedGoogle Scholar
  • 18 Nicolle F V, Matti B A, Scamp T, Scamp T. Dermal and facial autografts in facial aesthetic surgery.  Aesthetic Plast Surg. 1992;  16 219-225
    CrossrefPubMedGoogle Scholar
  • 19 Staebel C, Verheyden C N. The use of dermal fat grafts for the correction of secondary cleft lip deformities.  Plast Reconstr Surg. 2009;  123 151e-152e
    CrossrefPubMedGoogle Scholar
  • 20 Smith B, Bosniak S, Nesi F, Lisman R. Dermis-fat orbital implantation: 118 cases.  Ophthalmic Surg. 1983;  14 941-943
    PubMedGoogle Scholar
  • 21 Williams H B, Crepeau R J. Free dermal fat flaps to the face.  Ann Plast Surg. 1979;  3 1-12
    PubMedGoogle Scholar
  • 22 Vaienti L, Soresina M, Menozzi A. Parascapular free flap and fat grafts: combined surgical methods in morphological restoration of hemifacial progressive atrophy.  Plast Reconstr Surg. 2005;  116 699-711
    CrossrefPubMedGoogle Scholar
  • 23 Asai S, Kamei Y, Nishibori K, Katoh T, Torii S. Reconstruction of Romberg disease defects by omental flap.  Ann Plast Surg. 2006;  57 154-158
    CrossrefPubMedGoogle Scholar
  • 24 Wang X, Qiao Q, Liu Z et al.. Free anterolateral thigh adipofascial flap for hemifacial atrophy.  Ann Plast Surg. 2005;  55 617-622
    CrossrefPubMedGoogle Scholar
  • 25 Zhang Y, Jin R, Shi Y, Sun B, Zhang Y, Qian Y. Pedicled superficial temporal fascia sandwich flap for reconstruction of severe facial depression.  J Craniofac Surg. 2009;  20 505-508
    CrossrefPubMedGoogle Scholar
  • 26 Upton J, Albin R E, Mulliken J B, Murray J E. The use of scapular and parascapular flaps for cheek reconstruction.  Plast Reconstr Surg. 1992;  90 959-971
    CrossrefPubMedGoogle Scholar
  • 27 Swinehart J M. Dermal grafting.  Dermatol Clin. 2001;  19 509-522
    CrossrefPubMedGoogle Scholar

Tristan L HartzellM.D. 

Division of Plastic and Reconstructive Surgery

Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115

Email: tristanhartzell@gmail.com

      >