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Flap Prefabrication and Stem Cell–Assisted Tissue Expansion: How We Acquire a Monoblock Flap for Full Face Resurfacing

Li, QingFeng MD, PhD; Zan, Tao MD, PhD; Li, Haizhou MD; Zhou, Shuangbai MD; Gu, Bin MD; Liu, Kai MD, PhD; Xie, Feng MD; Xie, Yun MD

Journal of Craniofacial Surgery: January 2014 - Volume 25 - Issue 1 - p 21–25
doi: 10.1097/01.scs.0000436743.75289.6b
Original Articles

Total face skin and soft-tissue defects remain one of the biggest challenges in reconstructive surgery. Reconstruction of the entire face with uniform coverage and delicate features is difficult to achieve. To avoid the patchwork result seen in multiple flaps and skin grafts, 1 monoblock flap that has similar color, texture, and thickness might be an ideal option to minimize the incisional scars and several surgical procedures but is unavailable with current approaches because of the lack of sufficient matched tissue and the unreliable blood supply for such a large flap. To acquire a monoblock flap for full face reconstruction, we combine the prefabricated flaps, skin overexpansion, and bone marrow mononuclear stem cell transplantation for total facial resurfacing. In this article, we present our experience from our case series that provides universally matched skin and near-normal facial contour. It is a reliable and an excellent reconstructive option for massive facial skin defect.

From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China.

Received September 6, 2013.

Accepted for publication September 30, 2013.

Address correspondence and reprint requests to QingFeng Li, MD, PhD, Department of Plastic and Reconstructive Surgery, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Rd, Shanghai 200011, People’s Republic of China; E-mail:;

This work was supported by grants from the National Natural Science Foundation of China (no. 30925034, 81101437) and the National Key Project of Scientific and Technical Supporting Programs Funded by Ministry of Science & Technology of China (no. 2012BAI11B03).

None of the authors have a financial interest in any of the products, devices, or drugs mentioned in this manuscript.

© 2014 by Mutaz B. Habal, MD.