Facial Plast Surg 2021; 37(06): 759-770
DOI: 10.1055/s-0041-1722981
Original Article

Considerations in Free Flap Reconstruction of the Midface

Daniel Hammer
1   Oral Oncology and Maxillofacial Reconstructive Microsurgery, Department of Oral and Maxillofacial Surgery, Naval Medical Center, San Diego, California
Aurora G. Vincent
2   Facial Plastic and Reconstructive Surgery, Facial Plastic Surgery Associates, Fort Worth, Texas
Fayette Williams
3   Division of Maxillofacial Oncology and Reconstructive Surgery, Department of Oral and Maxillofacial Surgery, John Peter Smith Hospital, Fort Worth, Texas
Yadranko Ducic
4   Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas
› Author Affiliations


Midface reconstruction has been a consistent challenge for reconstructive surgeons even with the significant advances in technology and technique achieved over the recent years. A meticulous preoperative assessment of the patient is required to properly assess the defect or anticipated defect, determine proper reconstructive surgical plan, and discuss expected functional and aesthetic outcomes with the patient. For years we have employed local flaps, regional flaps, obturators, alloplastic implants, free flaps, or a combination of the previously mentioned techniques to address complex midface reconstruction. Free flap reconstruction in the midface requires special considerations for the pedicle, flap selection, and flap design to ensure an optimal outcome. The introduction of virtual surgical planning for reconstruction has enhanced patient outcomes to include advances in immediate dental rehabilitation at the time of free flap surgery. Postoperative considerations including quality of life, functional and aesthetic outcomes, and management of complications will also be discussed.

Publication History

Publication Date:
15 February 2021 (online)

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