Control of the Suborbital Cheek in Pediatric Patients: Working in the Deep Plane

Reconstruction of suborbital cheek and lower eyelid defects can be challenging in pediatric patients due to the need for lower eyelid support, lack of reliable local tissue, and difficulties of scar concealment. The deep-plane cervicofacial rotation-advancement flap is a useful technique for cheek reconstruction in adults; however, its utility in the pediatric population has not been described. METHODS: Experience using the deep-plane Schrudde flap for large suborbital defects in pediatric patients is presented. RESULTS: Safe flap elevation and successful reconstruction requires utilization of critical anatomic landmarks, a standardized sequence of dissection and appropriate fixation.