Reconstruction of Midfacial Defect With Radial Forearm Free Flap

For head and neck reconstruction, especially for reconstruction of midfacial structure, we should consider cosmetic results, functional preservation, and survival of flap. Methods of reconstruction vary from skin graft to free flap. Among those, the radial forearm free flap (RFFF) can be a valuable alternative for defects of midfacial structures such as the eyelid, nose and lip because of its sufficiently long pedicles, lack of bulk and flexibility, all of which enable surgeons to shape the flap into the way they want, and also functionally complement it by using adjacent structures like the palmaris longus muscle tendon. Herein, we introduce various methods of employing RFFF with or without the palmaris longus tendon to get better aesthetic and functional outcomes in reconstruction of midfacial structure.