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Published on May 12, 2020
Atmodiwirjo P, Ramadan MR, Triatmoko SE, Arina MN. Multistages Aesthetic Refinement Post Anterolateral Thigh Free Flap in Head and Neck Reconstruction. J Plast Rekons 2020;7(1):38-42. DOI: https://doi.org/10.14228/jpr.v7i1.298
This is supplementary information from Jurnal Plastik Rekonstruksi (www.jprjournal.com) video article as follow:
TITLE Multistages Aesthetic Refinement Post Anterolateral Thigh Free Flap in Head and Neck Reconstruction
AUTHORS 1. Parintosa Atmodiwirjo Reconstructive Microsurgery Section, Division of Plastic Surgery, Faculty of Medicine Universitas Indonesia, dr. Cipto Mangunkusumo National Hospital. Jakarta, Indonesia. 2. Mohamad Rachadian Ramadan Reconstructive Microsurgery Section, Division of Plastic Surgery, Faculty of Medicine Universitas Indonesia, dr. Cipto Mangunkusumo National Hospital. Jakarta, Indonesia. 3. Sara Ester Triatmoko Reconstructive Microsurgery Section, Division of Plastic Surgery, Faculty of Medicine Universitas Indonesia, dr. Cipto Mangunkusumo National Hospital. Jakarta, Indonesia 4. Maryam Nur Arina Faculty of Medicine, Universitas Indonesia. Jakarta, Indonesia
ABSTRACT Introduction: Multi-stages refinement of a bulky flap after composite defects reconstruction of multiple facial units has been a challenging situation. Goals including restoration of periorbital and malar area and redefining the aesthetic aspects of the units as well as the surrounding nasolabial area with multiple refinements and microfat graft.
Methods: A 50-year-old male patient with a history of solitary fibrous tumor underwent wide excision of left periorbital, infraorbital, lateral nasal sidewall, and malar area. The defect is enclosed with Anterolateral Thigh Free Flap (ALT). Bulkiness of the flap, sunken left nasolabial, and asymmetric alar nasal unit were found during outpatient follow-up. These problems lead to the necessity of refinement procedure to reduce the bulkiness to improve the aesthetic outcome of the patient. Microfat graft was the method chosen to volumized the sunken nasolabial and asymmetric alar nasal unit.
Results: Patient is satisfied with the result due to improvement of alar nasal units symmetricity and reduced bulkiness of the flap area. No complication was observed.
Conclusion: Meticulous planning and staging of the surgical refinement procedures in conjunction with microfat graft results in good aesthetic outcome and satisfies the patient and reduces the possibility of complications.
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