Skip to main content
SpringerLink
Log in
Book cover

Non-Melanoma Skin Cancer and Cutaneous Melanoma pp 475–489Cite as

Cheek and Neck Reconstruction Following Cutaneous Neoplasm Resection

  • Chapter
  • First Online:

  • 1046 Accesses

Abstract

Surgical reconstruction of soft tissue defects following resection of cutaneous neoplasms in the cheek and neck area can be technically challenging. Reconstruction of resultant composite tissue defects must start by identifying missing layers and the characteristics of the surrounding tissue. In deep defects, it is important to consider the middle lamella or facial musculature. Functional deficits following cutaneous tumor resection must be carefully considered. In the case of full-thickness defects, it may also be necessary to reconstruct mucosal lining and possible bony defects. The surrounding skin should be assessed for color, texture, thickness, and hair-bearing status. Following a thorough assessment of the wound, an appropriate reconstructive plan can be formulated.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   189.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Cabrera RC, Zide BM. Cheek reconstruction. In: Aston SJ, Beasley RW, CHM T, editors. Grabb and Smith’s plastic surgery. Philadelphia: Lippincott-Raven; 1997. p. 501–12.

    Google Scholar 

  2. Roth DA, Longaker MT, Zide BM. Cheek surface reconstruction: best choices according to zones. Oper Tech Plast Reconstr Surg. 1998;5:26–36.

    Google Scholar 

  3. Rapstine ED, Knaus WJ, Thornton JF. Simplifying cheek reconstruction: a review of over 400 cases. Plast Reconstr Surg. 2012;129:1291–9.

    CAS  PubMed  Google Scholar 

  4. Soliman S, Hatef DA, Hollier LH Jr, Thornton JF. The rationale for direct linear closure of facial Mohs’ defects. Plast Reconstr Surg. 2011;127:142–9.

    CAS  PubMed  Google Scholar 

  5. Menick FJ. Reconstruction of the cheek. Plast Reconstr Surg. 2001;108:496–505.

    CAS  PubMed  Google Scholar 

  6. Kawashima T, Yamada A, Ueda K, Asato H, Harii K. Tissue expansion in facial reconstruction. Plast Reconstr Surg. 1994;94:944–50.

    CAS  PubMed  Google Scholar 

  7. Argenta LC, Watanabe MJ, Grabb WC. The use of tissue expansion in head and neck reconstruction. Ann Plast Surg. 1983;11:31–7.

    CAS  PubMed  Google Scholar 

  8. Wieslander JB. Tissue expansion in the head and neck: a 6-year review. Scand J Plast Reconstr Hand Surg. 1991;25:47–56.

    CAS  Google Scholar 

  9. Antonyshyn O, Gruss JS, Mackinnon SE, Zuker R. Complications of soft tissue expansion. Br J Plast Surg. 1988;41:239–50.

    CAS  PubMed  Google Scholar 

  10. Antonyshyn O, Gruss JS, Zuker R, Mackinnon SE. Tissue expansion in head and neck reconstruction. Plast Reconstr Surg. 1988;82:58–68.

    CAS  PubMed  Google Scholar 

  11. Walton R. Personal communication; 2006.

    Google Scholar 

  12. Koenen W, Felcht M, Vockenroth K, Sassmann G, Goerdt S, Faulhaber J. One-stage reconstruction of deep facial defects with a single layer dermal regeneration template. J Eur Acad Dermatol Venereol. 2011;25:788–93.

    CAS  PubMed  Google Scholar 

  13. Zook EG, Van Beek AL, Russell RC, et al. V-Y advancement flap for facial defects. Plast Reconstr Surg. 1980;65:786–97.

    CAS  PubMed  Google Scholar 

  14. Kalus R, Zamora S. Aesthetic considerations in facial reconstructive surgery: the V-Y flap revisited. Aesthet Plast Surg. 1996;20:83–6.

    CAS  Google Scholar 

  15. Kwon KH, Lee DG, Koo SH, Jo MS, Shin H, Seul JH. Usefulness of V-Y advancement flap for defects after skin tumor excision. Arch Plast Surg. 2012;39:619–25.

    PubMed  PubMed Central  Google Scholar 

  16. Pribaz JJ, Chester CHM, Barrall DT. The extended V-Y flap. Plast Reconstr Surg. 1992;90:275–80.

    CAS  PubMed  Google Scholar 

  17. Chan ST. A technique for undermining a V-Y subcutaneous island flap to maximise advancement. Br J Plast Surg. 1988;41:62–7.

    CAS  PubMed  Google Scholar 

  18. Heller L, Cole P, Kaufman Y. Cheek reconstruction: current concepts in managing facial soft tissue loss. Semin Plast Surg. 2008;22:294–305.

    PubMed  PubMed Central  Google Scholar 

  19. Yenidunya MO, Demirseren M, Uslu C. Large bilobed flap in the repair of face and neck defects. Eur J Plast Surg. 2004;27:131–4.

    Google Scholar 

  20. Chu EA, Byrne PJ. Local flaps I: Bilobed, rhombic, and cervicofacial. Facial Plast Surg Clin North Am. 2009;17:349–60.

    PubMed  Google Scholar 

  21. Juri J, Juri C. Advancement and rotation of large cervicofacial flap for cheek repairs. Plast Reconstr Surg. 1979;64:792–6.

    Google Scholar 

  22. Juri J, Juri C. Cheek reconstruction with advancement-rotation flaps. Clin Plast Surg. 1981;8:223–6.

    CAS  PubMed  Google Scholar 

  23. Kroll SS, Reece GP, Robb G, Black J. Deep-plane cervicofacial rotation-advancement flap for reconstruction of large cheek defects. Plast Reconstr Surg. 1994;94:88–93.

    CAS  PubMed  Google Scholar 

  24. Jacono AA, Rousso JJ, Lavin TJ. Comparing rates of distal edge necrosis in deep-plane vs subcutaneous cervicofacial rotation-advancement flaps for facial cutaneous Mohs defects. JAMA Facial Plast Surg. 2014;16:31. https://doi.org/10.1001/jamafacial.2013.20.

    Article  PubMed  Google Scholar 

  25. Shestak KC, Roth AG, Jones NF, Myers EN. The cervicopectoral rotation flap—a valuable technique for facial reconstruction. Br J Plast Surg. 1993;46:375–7.

    CAS  PubMed  Google Scholar 

  26. Becker DW. A cervicopectoral rotation flap for cheek coverage. Plast Reconstr Surg. 1978;61:868–70.

    PubMed  Google Scholar 

  27. Al-Shunnar B, Manson PN. Cheek reconstruction with laterally based flaps. Clin Plast Surg. 2001;28:283–96.

    CAS  PubMed  Google Scholar 

  28. Schrudde J, Beinhoff U. Reconstruction of the face by means of the angle-rotation flap. Aesthet Plast Surg. 1987;11:15–22.

    CAS  Google Scholar 

  29. Boutros S, Zide BM. Cheek and eyelid reconstruction: the resurrection of the angle rotation flap. Plast Reconstr Surg. 2005;116:1425–30.

    CAS  PubMed  Google Scholar 

  30. Haddock NT, Zide BM. Deep-plane angle rotation flap for reconstruction of perioral lesions. Ann Plast Surg. 2011;67:594–6.

    CAS  PubMed  Google Scholar 

  31. Champion R. Closure of full-thickness cheek loss by forehead flap. Br J Plast Surg. 1960;13:76–8.

    CAS  PubMed  Google Scholar 

  32. Margulis A, Amar D, Billig A, Adler N. Periorbital reconstruction with the expanded pedicled forehead flap. Ann Plast Surg. 2015;74(3):313–7.

    CAS  PubMed  Google Scholar 

  33. Hofer SO, Posch NA, Smit X. The facial artery perforator flap for reconstruction of perioral defects. Plast Reconstr Surg. 2005;115:996–1003.

    CAS  PubMed  Google Scholar 

  34. Liu DZ, Mathes DW, Zenn MR, Neligan PC. The application of indocyanine green fluorescence angiography in plastic surgery. J Reconstr Microsurg. 2011;27:355–64.

    CAS  PubMed  Google Scholar 

  35. Kannan RY, Mathur BS. Perforator flaps of the facial artery angiosome. J Plast Reconstr Aesthet Surg. 2013;66:e483–8.

    Google Scholar 

  36. Martin D, Pascal JF, Baudet J, Mondie JM, Farhat JB, Athoum A, Le Gaillard P, Peri G. The submental island flap: a new donor site. Anatomy and clinical applications as a free or pedicled flap. Plast Reconstr Surg. 1993;92:867–73.

    CAS  PubMed  Google Scholar 

  37. Demir Z, Kurtay A, Sahin U, Velidedeoğlu H, Celebioğlu S. Hair-bearing submental artery island flap for reconstruction of mustache and beard. Plast Reconstr Surg. 2003;112:423–9.

    PubMed  Google Scholar 

  38. Magden O, Edizer M, Tayfur V, Atabey A. Anatomic study of the vasculature of the submental artery flap. Plast Reconstr Surg. 2004;114:1719–25.

    PubMed  Google Scholar 

  39. Tang M, Ding M, Almutairi K, Morris SF. Three-dimensional angiography of the submental artery perforator flap. J Plast Reconstr Aesthet Surg. 2011;64:608–13.

    PubMed  Google Scholar 

  40. Pistre V, Pelissier P, Martin D, Lim A, Baudet J. Ten years of experience with the submental flap. Plast Reconstr Surg. 2001;108:1576–81.

    CAS  PubMed  Google Scholar 

  41. Fine NA, Pribaz JJ, Orgill DP. Use of the innervated platysma flap in facial reanimation. Ann Plast Surg. 1995;34:326–30.

    CAS  PubMed  Google Scholar 

  42. Ariyan S. The pectoralis major myocutaneous flap. A versatile flap for reconstruction in the head and neck. Plast Reconstr Surg. 1979;63:73–81.

    CAS  PubMed  Google Scholar 

  43. Peleg M, Sawatari Y, Lopez EA. Assessment of the functionality of the pectoralis major myocutaneous flap skin paddle. J Craniofac Surg. 2011;22:365–70.

    PubMed  Google Scholar 

  44. Maruyama Y, Nakajima H, Fujino T. A dynamic reconstruction of a facial defect with a pectoralis major myocutaneous flap. Br J Plast Surg. 1980;5:108–14.

    Google Scholar 

  45. Russell RC, Feller AM, Elliott LF, Kucan JO, Zook EG. The extended pectoralis major myocutaneous flap: uses and indications. Plast Reconstr Surg. 1991;88:814–23.

    CAS  PubMed  Google Scholar 

  46. Ahmad QG, Navadgi S, Agarwal R, Kanhere H, Shetty KP, Prasad R. Bipaddle pectoralis major myocutaneous flap in reconstructing full thickness defects of cheek: a review of 47 cases. J Plast Reconstr Aesthet Surg. 2006;59:166–73.

    PubMed  Google Scholar 

  47. Baek SM, Biller HF, Krespi YP, Lawson W. The lower trapezius island myocutaneous flap. Ann Plast Surg. 1980;5:108–14.

    CAS  PubMed  Google Scholar 

  48. Rosen HM. The extended trapezius myocutaneous flap for cranio-orbito facial reconstruction. Plast Reconstr Surg. 1985;75:318–27.

    CAS  PubMed  Google Scholar 

  49. Demergasso F, Piazza MV. Trapezius myocutaneous flap for reconstructive surgery for head and neck cancer: an original technique. Am J Surg. 1979;138:533–6.

    CAS  PubMed  Google Scholar 

  50. Uğurlu K, Ozçelik D, Hüthüt I, Yildiz K, Kilinç L, Baş L. Extended vertical trapezius myocutaneous flap in head and neck reconstruction as a salvage procedure. Plast Reconstr Surg. 2004;114:339–50.

    PubMed  Google Scholar 

  51. Pallua N, Magnus Noah E. The tunneled supraclavicular island flap: an optimized technique for head and neck reconstruction. Plast Reconstr Surg. 2000;105:842–51.

    CAS  PubMed  Google Scholar 

  52. Pallua N, von Heimburg D. Pre-expanded ultra-thin supraclavicular flaps for (full-) face reconstruction with reduced donor-site morbidity and without the need for microsurgery. Plast Reconstr Surg. 2005;115:1837–44.

    CAS  PubMed  Google Scholar 

  53. Pribaz JJ, Morris DJ, Mulliken JB. Three-dimensional folded free-flap reconstruction of complex facial defects using intra-operative modeling. Plast Reconstr Surg. 1994;93:285–93.

    CAS  PubMed  Google Scholar 

  54. Soutar DS, Scheker LR, Tanner NS, McGregor IA. The radial forearm flap: a versatile method for intra-oral reconstruction. Br J Plast Surg. 1983;36:1–8.

    CAS  PubMed  Google Scholar 

  55. Boorman JG, Green MF. A split Chinese forearm flap for simultaneous oral lining and skin cover. Br J Plast Surg. 1986;39:179–82.

    CAS  PubMed  Google Scholar 

  56. Niranjan NS, Watson DP. Reconstruction of the cheek using a ‘suspended’ radial forearm free flap. Br J Plast Surg. 1990;43:365–6.

    CAS  PubMed  Google Scholar 

  57. Bardsley AF, Soutar DS, Elliot D, Batchelor AG. Reducing morbidity in the radial forearm flap donor site. Plast Reconstr Surg. 1990;86:287–94.

    CAS  PubMed  Google Scholar 

  58. Sardesai MG, Fung K, Yoo JH, Bakker H. Donor-site morbidity following radial forearm free tissue transfer in head and neck surgery. J Otolaryngol Head Neck Surg. 2008;37:411–6.

    PubMed  Google Scholar 

  59. Patel NP, Matros E, Cordeiro PG. The use of the multi-island vertical rectus abdominis myocutaneous flap in head and neck reconstruction. Ann Plast Surg. 2012;69:403–7.

    CAS  PubMed  Google Scholar 

  60. Cordeiro PG, Chen CM. A 15-year review of midface reconstruction after total and subtotal maxillectomy: part I. Algorithm and outcomes. Plast Reconstr Surg. 2012;129:124–36.

    CAS  PubMed  Google Scholar 

  61. Pribaz JJ, Orgill DP, Epstein MD, Sampson CE, Hergrueter CA. Anterolateral thigh free flap. Ann Plast Surg. 1995;34:585–60.

    CAS  PubMed  Google Scholar 

  62. Demirkan F, Chen HC, Wei FC, Chen HH, Jung SG, Hau SP, Liao CT. The versatile anterolateral thigh flap: a musculocutaneous flap in disguise in head and neck reconstruction. Br J Plast Surg. 2000;53:30–6.

    CAS  PubMed  Google Scholar 

  63. Huang WC, Chen HC, Jain V, Kilda M, Lin YD, Cheng MH, Lin SH, Chen YC, Tsai FC, Wei FC. Cheek defects involving the oral commissure, using chimeric flaps from the thigh lateral femoral circumflex system. Plast Reconstr Surg. 2002;109:433–41.

    PubMed  Google Scholar 

  64. Jeng SF, Kuo YR, Wei FC, Su CY, Chien CY. Reconstruction of concomitant lip and cheek through-and-through defects with combined free flap and an advancement flap from the remaining lip. Plast Reconstr Surg. 2004;113:491–8.

    PubMed  Google Scholar 

  65. Koshima I, Yamamoto H, Hosoda M, Moriguchi T, Orita Y, Nagayama H. Free combined composite flaps using the lateral circumflex femoral system for repair of massive defects of the head and neck regions: an introduction to the chimeric flap principle. Plast Reconstr Surg. 1993;92:411–9.

    CAS  PubMed  Google Scholar 

  66. Kuo YR, Jeng SF, Kuo MH, Huang MN, Liu YT, Chiang YC, Yeh MC, Wei FC. Free anterolateral thigh flap for extremity reconstruction: clinical experience and functional assessment of donor site. Plast Reconstr Surg. 2001;107:1766–71.

    CAS  PubMed  Google Scholar 

  67. Rohrich RJ, Cherry GW, Spira M. Enhancement of skin-flap survival using nitroglycerin ointment. Plast Reconstr Surg. 1984;73:943–8.

    CAS  PubMed  Google Scholar 

  68. Jowett N, Mlynarek AM. Reconstruction of cheek defects: a review of current techniques. Curr Opin Otolaryngol Head Neck Surg. 2010;18:244–54.

    PubMed  Google Scholar 

  69. Harris GJ, Perez N. Anchored flaps in post-Mohs reconstruction of the lower eyelid, cheek, and lateral canthus: avoiding eyelid distortion. Ophthal Plast Reconstr Surg. 2003;19:5–13.

    PubMed  Google Scholar 

  70. Robinson JK. Suspension sutures in facial reconstruction. Dermatol Surg. 2003;29:386–93.

    PubMed  Google Scholar 

Download references

Acknowledgment

Financial Disclosures and Products: Neither author has any commercial associations or financial interests in the ideas, techniques, or products described or referenced in this book chapter.

Author information

Authors and Affiliations

  1. Division of Plastic Surgery, Brigham and Women’s Hospital Trauma and Burn Center, Harvard Medical School, Boston, MA, USA

    Indranil Sinha

  2. Division of Plastic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Julian J. Pribaz

Authors
  1. Indranil Sinha
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Julian J. Pribaz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Julian J. Pribaz .

Editor information

Editors and Affiliations

  1. Emeritus Professor, Plastic, Reconstructive and Aesthetic Surgery, National and Kapodistrian University of Athens Medical School, Athens, Greece

    Othon Papadopoulos

  2. Professor and Chairman, Department of Plastic Surgery and Burns, Alexandroupoli University Hospital, Democritus University of Thrace, Alexandroupoli, Greece

    Nikolaos A. Papadopulos

  3. Academic Fellow, National and Kapodistrian, University of Athens, Medical School, Athens, Greece

    Grigorios Champsas

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Sinha, I., Pribaz, J.J. (2020). Cheek and Neck Reconstruction Following Cutaneous Neoplasm Resection. In: Papadopoulos, O., Papadopulos, N.A., Champsas, G. (eds) Non-Melanoma Skin Cancer and Cutaneous Melanoma. Springer, Cham. https://doi.org/10.1007/978-3-030-18797-2_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-18797-2_12

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-18795-8

  • Online ISBN: 978-3-030-18797-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation