Use of expanded deltopectoral skin flaps for facial reconstruction after sizeable benign tumor resections

Abstract

The overall unsightliness of expansive benign facial tumors imposes both physical and mental suffering. Although excision is generally the optimal recourse in such instances, reconstructing the subsequent surgical defects is always a critical issue. Herein, we have described our experiences using expanded deltopectoral skin flaps to manage large facial wounds after excising benign tumors. Our endeavor called for retrospective review of 22 patients presenting between July 2007 and March 2017 with various facial growths, including hemangiomas, nevi, and neurofibromas. Depending upon areas of facial involvement, unilateral or bilateral deltopectoral skin flaps were expanded. The stepwise process was as follows: expander implantation, flap transfer, pedicle delay, and eventual separation. Ultimately, all 22 patients undergoing this procedure expressed satisfaction with the results in terms of skin texture, color, and flexibility. This particular method may thus be a reasonable choice for repairing sizeable defects in the wake of benign facial tumor excisions.

Keywords: Deltopectoral flap; benign facial tumors; pedicle flap; tissue expansion.

Conflict of interest statement

None.

Figures

Figure 1

Patient 1: (A) 19-year-old male patient presenting with black skin patch (12×10 cm), slightly elevated with several irregular protrusions; (B) Right deltopectoral skin expander (500 ml) first implanted; (C) Deltopectoral flap (13×10 cm) raised after 2 months for transfer to face; (D) Pedicle divided 3 weeks later, completely replacing benign tumor; and (E) Aesthetically satisfactory facial contours at 6 months.

Figure 2

Patient 2: (A) 12-year-old boy presenting with ulcerated scar (8×12 cm) of right face after hemangioma irradiation; (B) Pre-expanded deltopectoral skin flap designed to replace lesion using 400-ml expander implanted into right deltopectoral region; (C) Deltopectoral flap (9×13 cm) raised from expanded skin 2 months later and transferred to face; and (D) Once healed, no apparent contour deformity of chest, and patient satisfied with outcome 8 years after surgery.

Figure 3

Patient 3: (A) 19-year-old woman presenting with black skin patch (10×5 cm) of right face; (B) Pre-expanded deltopectoral skin flap designed to replace lesion using 800-ml expander implanted into right deltopectoral region; (C) Expanded deltopectoral flap (11×7 cm) raised and transferred to facial defect after lesion resected; and (D) Pedicle division performed 3 weeks later, yielding aesthetically satisfactory facial contours 1 year after surgery.