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Facial contour deformity correction with microvascular flaps based on the 3-dimentional template and facial moulage

INTRODUCTION: Facial contour deformities presents with varied aetiology and degrees severity. Accurate assessment, selecting a suitable tissue and sculpturing it to fill the defect is challenging and largely subjective. Objective assessment with imaging and software is not always feasible and prepar...

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Autores principales: Kadam, Dinesh, Pillai, Vijay, Bhandary, Sanath, Hukkeri, Rajesh Y., Kadam, Manjushree
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publication & Media Pvt Ltd 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3897098/
https://www.ncbi.nlm.nih.gov/pubmed/24459343
http://dx.doi.org/10.4103/0970-0358.122000
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author Kadam, Dinesh
Pillai, Vijay
Bhandary, Sanath
Hukkeri, Rajesh Y.
Kadam, Manjushree
author_facet Kadam, Dinesh
Pillai, Vijay
Bhandary, Sanath
Hukkeri, Rajesh Y.
Kadam, Manjushree
author_sort Kadam, Dinesh
collection PubMed
description INTRODUCTION: Facial contour deformities presents with varied aetiology and degrees severity. Accurate assessment, selecting a suitable tissue and sculpturing it to fill the defect is challenging and largely subjective. Objective assessment with imaging and software is not always feasible and preparing a template is complicated. A three-dimensional (3D) wax template pre-fabricated over the facial moulage aids surgeons to fulfil these tasks. Severe deformities demand a stable vascular tissue for an acceptable outcome. MATERIALS AND METHODS: We present review of eight consecutive patients who underwent augmentation of facial contour defects with free flaps between June 2005 and January 2011. De-epithelialised free anterolateral thigh (ALT) flap in three, radial artery forearm flap and fibula osteocutaneous flap in two each and groin flap was used in one patient. A 3D wax template was fabricated by augmenting the deformity on facial moulage. It was utilised to select the flap, to determine the exact dimensions and to sculpture intraoperatively. Ancillary procedures such as genioplasty, rhinoplasty and coloboma correction were performed. RESULTS: The average age at the presentation was 25 years and average disease free interval was 5.5 years and all flaps survived. Mean follow-up period was 21.75 months. The correction was aesthetically acceptable and was maintained without any recurrence or atrophy. CONCLUSION: The 3D wax template on facial moulage is simple, inexpensive and precise objective tool. It provides accurate guide for the planning and execution of the flap reconstruction. The selection of the flap is based on the type and extent of the defect. Superiority of vascularised free tissue is well-known and the ALT flap offers a versatile option for correcting varying degrees of the deformities. Ancillary procedures improve the overall aesthetic outcomes and minor flap touch-up procedures are generally required.
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spelling pubmed-38970982014-01-23 Facial contour deformity correction with microvascular flaps based on the 3-dimentional template and facial moulage Kadam, Dinesh Pillai, Vijay Bhandary, Sanath Hukkeri, Rajesh Y. Kadam, Manjushree Indian J Plast Surg Original Article INTRODUCTION: Facial contour deformities presents with varied aetiology and degrees severity. Accurate assessment, selecting a suitable tissue and sculpturing it to fill the defect is challenging and largely subjective. Objective assessment with imaging and software is not always feasible and preparing a template is complicated. A three-dimensional (3D) wax template pre-fabricated over the facial moulage aids surgeons to fulfil these tasks. Severe deformities demand a stable vascular tissue for an acceptable outcome. MATERIALS AND METHODS: We present review of eight consecutive patients who underwent augmentation of facial contour defects with free flaps between June 2005 and January 2011. De-epithelialised free anterolateral thigh (ALT) flap in three, radial artery forearm flap and fibula osteocutaneous flap in two each and groin flap was used in one patient. A 3D wax template was fabricated by augmenting the deformity on facial moulage. It was utilised to select the flap, to determine the exact dimensions and to sculpture intraoperatively. Ancillary procedures such as genioplasty, rhinoplasty and coloboma correction were performed. RESULTS: The average age at the presentation was 25 years and average disease free interval was 5.5 years and all flaps survived. Mean follow-up period was 21.75 months. The correction was aesthetically acceptable and was maintained without any recurrence or atrophy. CONCLUSION: The 3D wax template on facial moulage is simple, inexpensive and precise objective tool. It provides accurate guide for the planning and execution of the flap reconstruction. The selection of the flap is based on the type and extent of the defect. Superiority of vascularised free tissue is well-known and the ALT flap offers a versatile option for correcting varying degrees of the deformities. Ancillary procedures improve the overall aesthetic outcomes and minor flap touch-up procedures are generally required. Medknow Publication & Media Pvt Ltd 2013 /pmc/articles/PMC3897098/ /pubmed/24459343 http://dx.doi.org/10.4103/0970-0358.122000 Text en Copyright: © Indian Journal of Plastic Surgery http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kadam, Dinesh
Pillai, Vijay
Bhandary, Sanath
Hukkeri, Rajesh Y.
Kadam, Manjushree
Facial contour deformity correction with microvascular flaps based on the 3-dimentional template and facial moulage
title Facial contour deformity correction with microvascular flaps based on the 3-dimentional template and facial moulage
title_full Facial contour deformity correction with microvascular flaps based on the 3-dimentional template and facial moulage
title_fullStr Facial contour deformity correction with microvascular flaps based on the 3-dimentional template and facial moulage
title_full_unstemmed Facial contour deformity correction with microvascular flaps based on the 3-dimentional template and facial moulage
title_short Facial contour deformity correction with microvascular flaps based on the 3-dimentional template and facial moulage
title_sort facial contour deformity correction with microvascular flaps based on the 3-dimentional template and facial moulage
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3897098/
https://www.ncbi.nlm.nih.gov/pubmed/24459343
http://dx.doi.org/10.4103/0970-0358.122000
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