REPLANTATION OF AMPUTATED FACIAL TISSUES WITH MICROVASCULAR ANASTOMOSIS

A challenge to the microsurgeon is perfecting the technique of replant ation of small pieces of facial tissue, mainly because of the extremel y small size of the arteries as well as a lack of suitable veins for d rainage. In the past 4 years, we have had seven cases of facial amputa tions, which included one scalp, two nasal tips, two ears, one lower l ip, and one eyebrow. All of these patients were replanted/revasculariz ed by microvascular anastomosis. Only two of the cases had suitable ve ins for anastomosis. Alternative techniques used for improving venous outflow were arterio-venous fistula, chemical leeches, and pin pricks. Four of the cases were completely successful, two cases had partial l oss of the replant, and one case failed due to absence of venous drain age. In facial amputation, an aggressive microsurgical attempt will re sult in more tissue surviving and a better cosmetic outcome than in an y other reconstructive procedures.