Abstract
Morphological restoration of the face in complex tissue defects involving midface remains a great challenge for any surgeon. Tridimensional tomographic analyze gives excellent quality images of the defect and modern technology can provide prosthesis for skeletal replacement at least. Prelaminated free flaps are a method to reestablish morphological aspect and restore lost functions. We describe here a case of 30 years old male patient, victim of a self-inflicted gunshot wound, with a complex defect of the midface. A three-dimensional skull reconstruction was performed in order to restore the midface morphology. Following an initial uneventful evolution, at 2 weeks we noticed partial flap necrosis, with a small island of implant denudation in the mouth and significant decrease of the hypodermis, but with the integrity of the skin covering the implant. Despite of this, we observed a good general condition and improvement of patient’s mental health, swallowing restoration and phonation improvement.
Keywords: titanium plate; human face restoration; anterolateral thigh prelaminated free flap; face reconstruction; microsurgery