PMC7175762_01
A 35-year-old male with multiple facial fracture (a and b). The maxillomandibular fixation was placed (c). Open reduction internal fixation (ORIF) of the frontal sinus fractures with plate and mesh (d and e). Fat grafting was performed to correct his temporal fossa depression on both sides at 10 months later (f), 14 months later before rhinoplasty (g), and the final result at 10 months after his last nasal surgery (h)
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A 35-year-old male fell from a ladder while roofing, sustaining LeFort 1 and paramedian palatal fracture; right NOE fracture; left zygomaticomaxillary complex (ZMC) fracture; fractures of the bilateral supraorbital rims, orbital floors and lateral walls and nasal bones; and comminuted fractures of the anterior and posterior walls of the frontal sinus (Fig. 1a, b). He underwent creation of a submental airway and was placed in maxillomandibular fixation (Fig. 1c). ORIF of frontal sinus fractures was performed with plate and mesh (Fig. 1d, e). Ten months later he required fat grafting to the temporal fossa (7 cc to each side) for temporal wasting and revision of a left eyelid scar (Fig. 1f). Fourteen months following initial trauma he underwent rhinoplasty and inferior turbinectomy for traumatic nasal deformity and nasal airway (Fig. 1g). Fig 1h shows the final result at 10 months after his last nasal surgery.
PMC7175762_02
A 46-year-old male underwent initial external fixator placement for mandibular stabilization after gunshot wound to his left face (a). He underwent open reduction internal fixation (ORIF) of complex bilateral mandible fractures with reconstruction plates and ORIF of left communized midface fractures with multiple miniplates (b and c). A left supraclavicular artery (SCA) flap was raised and transferred inside the mouth to provide intraoral soft-tissue coverage and restore intraoral lining (d, e and f), with a good reconstructive result at a 3-year follow-up (g and h)
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The patient underwent initial external fixator placement for mandibular stabilization prior to transfer to our care (Fig. 2a). He subsequently underwent ORIF of complex bilateral mandible fractures with reconstruction plates and ORIF of left communized midface fractures with multiple miniplates (Fig. 2b, c). A left SCA flap was raised and transferred inside the mouth to provide intraoral soft-tissue coverage and restore intraoral lining (Fig. 2d, e, f). He subsequently underwent two debulking procedures of the intraoral supraclavicular flap at 4 and 36 months, respectively, and had a good reconstructive result at a 3-year follow-up (Fig. 2g, h).
PMC7175762_03
An 18-year-old male sustained a degloving injury to the left face and temporal scalp (a), with loss of the left zygomatic arch and the portion of the zygomatic body and lateral orbital wall (b). The zygomatic body and lateral orbital wall were reconstructed with Medpore implants (c and d), his extensive facial soft-tissue coverage was achieved with a free anterolateral thigh perforator flap from the left thigh (e). The appearance several months later after initial reconstruction (f) and has had a good result after above multiple procedures during a 25-month follow-up (g and h)
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An 18-year-old male suffered a degloving injury of the left face and temporal scalp in an unhelmeted motorcycle accident (Fig. 3a). His bony injuries included loss of the left zygomatic arch and a portion of the zygomatic body and lateral orbital wall (Fig. 3b). ALT perforator flap from the left thigh (Fig. 3e). After allowing for soft-tissue swelling to subside, he presented several months later in need of resuspension of the ALT flap and lateral canthopexy for ectropion (Fig. 3f). After further soft-tissue atrophy of the ALT free flap he underwent flap debulking, mid-facelift with Medpore malar implant placement for augmentation of the deficient ZMC and even lateral canthoplasty. During a 25-month follow-up, he has had a good result after the above multiple procedures (Fig. 3g, h).