ABSTRACT
Background@#Reconstruction after removal of a malignant tumor in the head and neck region is crucial for restoring tissue integrity, function, and aesthetics. We retrospectively analyzed patients who underwent intraoral reconstruction surgery using radial forearm free flaps (RFFF) and anterolateral thigh free flaps (ALT) at a single institution to provide more information supporting the choice of a reconstruction method after removal of head and neck cancer. @*Methods@#The charts of 708 patients who underwent head and neck reconstruction between 1998 and 2018 at the Department of Plastic and Reconstructive Surgery at our institution were retrospectively reviewed. Patients’ age, sex, and history of radiation therapy, diabetes mellitus, and smoking were retrieved. The primary cancer site, types of defects, and complications were investigated. @*Results@#Overall, 473 and 95 patients underwent reconstruction surgery with RFFF and ALT, respectively. RFFF was more often used in patients with cancers of the pharynx, larynx, esophagus, or tonsil, while ALT was more frequently used in patients with cancers of the mouth floor with tonsil or tongue involvement. The proportion of patients undergoing ALT increased gradually. Flap failure and donor site morbidities did not show significant differences between the two groups. @*Conclusions@#RFFF and ALT flaps resulted in similar outcomes in terms of flap survival and donor site morbidity. ALT can be an option for head and neck reconstruction surgery in patients with large and complex defects or for young patients who want to hide their donor site scars.
ABSTRACT
Subpectoral implant insertion is considered to be the standard procedure for breast augmentation and reconstruction. However, in some patients who have undergone breast augmentation or reconstruction surgery with a prosthesis, implant removal may be required for various reasons, including infection or implant rupture. According to a literature review, the standard technique for implant removal has not been thoroughly investigated. This study aimed to report the case of a patient who developed animation deformity after implant removal and to suggest a technique for preventing such complications. A 51-year-old woman underwent breast augmentation surgery with silicone implants. However, the patient complained of an unpleasant foreign body sensation; hence, the implant was removed 6 months after the first operation. After removal of the implant, undesirable movement of the chest wall on both breasts occurred. Revision surgery under general anesthesia was planned 18 months after implant removal. Capsulectomy was performed on both sides, and the pectoralis major muscle was completely isolated and repositioned. The undesirable movement in the skin of the chest wall disappeared postoperatively. This case suggests the need for capsulectomy and repositioning of the pectoralis muscle to its original position during implant removal.