• Archives of Craniofacial Surgery
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• v.18 no.3
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• pp.172-178
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• 2017

Background: The conventional cervicofacial flap may cause the aesthetic problem of sideburns with a mismatched shape and arrangement. We developed a modified method with the goals of minimizing the destruction of the shape and arrangement of the sideburns and minimizing complications in comparison with the conventional method. Methods: The incision line was designed to descend just in front of the sideburns, without passing through them, and then to ascend with the sideburns posteriorly when a cervicofacial flap is performed, unlike the conventional method. Patients in whom this method was applied (group B) and patients who underwent surgery using the conventional method (group A) were investigated in a retrospective study. The method was evaluated by assessing changes in the arrangement of the sideburns and patients' satisfaction, and differences in the complication rate. Results: In group A, 23 of the 31 patients experienced changes in the arrangement of their sideburns. Most patients who experienced a change in the arrangement of their sideburns were dissatisfied with the change. The patients in group B did not experience such changes, and the defects were well reconstructed. Most of them were satisfied with the final sideburn arrangement. Conclusion: A novel method was used to preserve the sideburns while performing a cervicofacial flap. As a result, the appearance of the sideburns was well preserved and the satisfaction of patients was also high. Moreover, this technique could also prove useful for reconstruction without any increase in complications compared to the conventional method.

• Korean Journal of Head & Neck Oncology
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• v.11 no.1
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• pp.47-55
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• 1995

A large lateral facial defects especially a through and through defect of the cheek remains as challenging field of reconstruction for the head and neck surgeons. Closure of these wounds is technically troublesome due to the magnitude and location of the soft tissue and skin defect, functional and aesthetic consideration. optimal cancer surveillance, and desire for good nourishment. Most traditional methods dealing with these defects, including split-thickness skin graft, local and regional flaps as well as musculocutaneous flaps have their limitations. We applied four different methods for these reconstruction in four cases. We utilized temporal muscle flap, forearm free flap and secondary healing for repair of mucosal defects, and medial base cervicopectoral flap, pectoralis major myocutaneous flap and cervicofacial flap for the reconstruction of external skin defects. In one case, both sides were reconstructed with single forearm free flap. In our experiences, secondary healing could be one of the useful method for mucosal repair in the defect between upper and lower gingivobuccal sulcus. However, forearm free flap was thought to be more ideal for the cases with mandibulectomy. For the external repair, the regional skin flap was considered to be superior to pectoralis major myocutaneous flap or forearm free flap especially on color matching.

• Korean Journal of Head & Neck Oncology
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• v.4 no.1
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• pp.21-28
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• 1988

Skin replacement in large cheek defects after excision of benign or malignant tumor on the face is a challenging task. The physical characteristics of cheek skin are matched best by adjacent skin. Various methods of reconstructing of the facial surface such as forehead flap, distant flap, or a full thickness or split thickness skin graft have replaced adjacent tissue for coverage in many cases. We have reviewed ten cases of aesthetic reconstruction of the face after resection of the facial skin tumor within the last 5 years. The first group of 3 patients were reconstructed with split thickness skin graft from the scalp or lower abdomen. The second group of patients were reconstructed with cheek flap. The third group of 3 patients were reconstructed with cervicofacial flap. The last 2 patients were reconstructed with nasolabial flap & island falp respectively. The advantages from our experience with various method of coverage are its hidden donor area & good color match with the facial skin & increased success rate.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.12 no.1
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• pp.210-214
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• 1990

We used cervicofacial flap in reconstruction of Cheek detects with good results. So we recommended its use in reconstruction of large cheek defects.

• Korean Journal of Head & Neck Oncology
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• v.24 no.2
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• pp.203-206
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• 2008

Objectives：DFSP(Dermatofibrosarcoma protuberans) is an uncommon, slowly growing, locally invasive malignant tumor that usually presents as a painless, often long-standing mass arising in the dermis of skin. It occurs most frequently on the trunk and proximal parts of the limbs, less commonly in the head and neck region and has a frequent tendency to recur after surgical excision. Clinically, the initial appearance of the tumor similar to that of benign tumor such as keloid and dermatofibroma. Therefore, accurate clinical diagnosis and adequate surgical excision are important. Materials and Methods：We experienced 6 patients of DFSP in head and neck during the recent 6 years, 5 male and 1 female patients. The age of the patients ranged from 31 to 66. As reconstructive methods, the authors used cervicofacial flap, trapezius musculocutaneous flap, TRAM flap, anterolateral thigh free flap and skin graft. Results：The patients were followed up after operation from 24 to 79 months and all remained free of disease except one case, who occurred at forehead area. Conclusion：We present the experience of 6 cases of DFSP occurred in head and neck. We obtained satisfactory results with appropriate diagnosis and treatment which wide excision with surgical margins 3-5cm. We also present an operative plan of this locally aggressive and highly recurrent tumor.

• Archives of Plastic Surgery
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• v.36 no.5
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• pp.629-636
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• 2009

Purposes: Wide scars occurring on the lower face and neck are a source of both functional and esthetic problems. Consequently, we can use skin grafts, pedicled flaps, free flaps, and tissue expansion for the reconstruction of this area. Compared with other reconstruction techniques, tissue expansion is advantageous in that it enables the maintenance of a color and texture similar to that of the adjacent tissue. However, the conventional method of tissue expansion has been reported to lead to an unnatural cervicomental angle and to the deformity of adjacent structures. We have therefore made efforts to prevent these problems through the use of several operative procedures. Methods: Forty-one patients with lower facial and cervical scars underwent tissue expansion. The tissue expansion was performed using a rectangular-shaped Nagosil$^{(R)}$ tissue expansion device. On insertion of the tissue expander, the intermediate area of superficial fat layer was dissected and then the tissue expander was inserted to make a flap that was as thin as possible. In advancement of the flap, a capsule-formed by the tissue expander-was used for the interrupted fixed suture of the flap to the fascia of the platysma muscle of the neck. This procedure was performed multiple times and also performed between the flap and the periosteum of the mandible, such that the tension was removed during the suture of the flap margin. Finally, the patients were fitted with a Jobst$^{(R)}$ facial garment in order to stabilize the operation site at least twelve months. Results: The most prevalent location of the scar was the cheek (15 cases), followed by the chin in 14 cases and the neck in 12 cases. The mean size of scar was $55.7{\pm}39.4cm^2$. Conclusions: Using our procedures, we have experienced no significant deformities and have also achieved a more natural cervicomental angle in the patients.