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J Reconstr Microsurg 2012; 28(05): 319-326
DOI: 10.1055/s-0032-1311690
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Forehead Reconstruction with Microvascular Flaps: Utility of Aesthetic Subunits

Claude Muresan
1   Department of Surgery, Union Memorial Hospital, Baltimore, Maryland
,
Helen G. Hui-Chou
2   Department of Plastic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
3   Division of Plastic, Reconstructive, and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, Baltimore, Maryland
,
Amir H. Dorafshar
2   Department of Plastic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
3   Division of Plastic, Reconstructive, and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, Baltimore, Maryland
,
Paul N. Manson
2   Department of Plastic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
3   Division of Plastic, Reconstructive, and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, Baltimore, Maryland
,
Eduardo D. Rodriguez
2   Department of Plastic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
3   Division of Plastic, Reconstructive, and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, Baltimore, Maryland
› Author Affiliations
Further Information

Publication History

21 September 2011

22 December 2011

Publication Date:
20 April 2012 (online)

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Abstract

Background Current literature describes the forehead as one aesthetic subunit of the face. We argue for the usefulness of aesthetic forehead subunits when microvascular flap reconstruction is required. Key to utilization of microvascular flaps for restoration of forehead subunits is an understanding of the patient population and defect characteristics most amiable to treatment.

Methods We conducted an International Review Board–approved retrospective chart review of nine consecutive patients who had undergone free flap reconstruction for large forehead defects.

Results The patients' foreheads included one paramedian defect; one central and paramedian defect; four central, paramedian, and lateral defects; and three lateral defects. Seven patients had ulnar forearm flaps and two had anterolateral thigh flaps. The success rate was 100%.

Conclusion A forehead subunit classification system has been devised that provides a suitable option for cases that benefit from distant tissue replacement in a single stage, while preserving the principles of aesthetic replacement.

Keywords

forehead aesthetic subunit - forehead microvascular flap - paramedian - central - lateral forehead subunits
 

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