Pedicled superficial temporal fascia sandwich flap for reconstruction of severe facial depression

Facial soft tissue hypoplasia is a prominent feature of Parry-Romberg syndrome and hemifacial microsomia. Superficial temporal fascia has been used in the clinical application of the contour restoration, but it is too thin to reconstruct severe facial depression. To improve the thickness of the transplanted tissue flap, the pedicled superficial temporal fascia sandwich complex flap was designed for the reconstruction of severe facial depression and evaluation of its effect. There were 2 kinds of these complex flaps. The first kind was 2 free dermis-fat flaps fixed onto the superficial temporal fascia, which were applied in large and deep depression. The second was a piece of free dermis-fat flap sandwiched between the folded superficial temporal fascia, which were applied in small but deep upper-midface depression. Fifteen patients with facial depression deformities were involved in this study, in which 8 patients had Parry-Romberg syndrome, 4 patients had hemifacial microsomia, and 3 patients had traumatic facial depression. Postoperative follow-up for 2 to 24 months showed that the method had a good cosmetic result. Based on the results of our patients in this series, the surgical results were favorable, and it is a simple procedure and yields effective, safe, and satisfactory results.