MANAGEMENT OF FACIAL CONTOUR DEFORMITIES WITH DEEPITHELIALIZED LATERAL INTERCOSTAL FREE-FLAP

Ten cases suffering from facial contour deformities caused by loss of subcutaneous tissue are presented. Three cases had hemifacial microsom ia, 3 had postmaxillectomy collapsed cheek, while the remaining 4 pati ents had Romberg's disease, All cases were treated by the insertion of a deepithelialized, revascularized lateral intercostal flap. The flap s used had dimensions ranging from 9 cm x 6 cm to 12 cm x 14 cm. The v ascular pedicle of the flap is the lateral cutaneous branch of one of the lower four posterior intercostal bundles (usually the tenth or the eleventh). The flap is designed to have the pedicle in its center, th us allowing defattening of the edges at the primary surgery and minimi zing the need for secondary debulking. Nine flaps were successful and one failed. All successful flaps gave a permanent and satisfactory cor rection of the deformity. The difficulties and advantages of the flap are presented.