Opposing Transposition Flaps

If the primary reconstruction flap can be raised in the preauricular area (Fig. 8.18a), the secondary defect can be closed with an inferiorly based retroauricular flap. The tertiary defect can then be covered by mobilization (Fig. 8.18) or with a thick split skin graft (e.g., from the buttock).

Burows Triangle

Fig. 8.16a, b Skin advancement from the retroauricular area.

Fig. 8.16a, b Skin advancement from the retroauricular area.

Burows Triangle

Fig. 8.17 Burow's flap advancement.

a Wedge-shaped defect with a superior base. A retroauricular Burow's triangle is excised. b The completed repair. c A circular defect is covered with a rotation flap from the upper neck. d The completed repair.

Fig. 8.17 Burow's flap advancement.

a Wedge-shaped defect with a superior base. A retroauricular Burow's triangle is excised. b The completed repair. c A circular defect is covered with a rotation flap from the upper neck. d The completed repair.

Rotational Flap

a Cheek defect is repaired with a preauricular transposition flap (1). A second, inferiorly based flap is also raised (2). b The completed repair.

a Cheek defect is repaired with a preauricular transposition flap (1). A second, inferiorly based flap is also raised (2). b The completed repair.

Neck Flap Repair

Fig. 8.19 Posteriorly based bilobed flap from the cheek and submandibular region

(Weerda 1978 b, 1980 c). a Large defect involving the posterior upper cheek and the auricle. (1) One lobe of the flap is outlined below the defect. (2) A second lobe is outlined in the submandibular area. Burow's triangles are excised to close the secondary defects. b The completed repair.

Fig. 8.19 Posteriorly based bilobed flap from the cheek and submandibular region

(Weerda 1978 b, 1980 c). a Large defect involving the posterior upper cheek and the auricle. (1) One lobe of the flap is outlined below the defect. (2) A second lobe is outlined in the submandibular area. Burow's triangles are excised to close the secondary defects. b The completed repair.

Lateral Cheeks

Fig. 8.20 Lateral cheek rotation of Weerda (1980 c).

Fig. 8.20 Lateral cheek rotation of Weerda (1980 c).

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