Objective: To retrospectively evaluate the use of soft-tissue free-flap reconstruction for midfacial defects, focusing on defect characteristics, flap selection, recipient vessels, postoperative complications, and functional outcomes.Materials and Methods: A retrospective analysis was conducted on patients who received free-flap reconstruction for midfacial defects from 2021 to 2023. Demographic data, defect classifications, flap selections, recipient vessels, complications, and postoperative outcomes were examined.Results: Fasciocutaneous flaps, primarily anterolateral thigh (ALT) and latissimus dorsi (LD) flaps, were used in all cases. The facial artery and internal jugular veins were the most commonly used recipient systems for microsurgical anastomosis. Complications occurred in 36.4% of patients, including one flap loss and manageable postoperative events. Functional restoration included effective dead space obliteration, basal orbital support, oral-nasal separation, swallowing, speech preservation, and oral competence. Patients receiving adjuvant therapy had higher complication rates.Conclusions: Fasciocutaneous free flaps offer a dependable and efficient reconstructive solution for midfacial defects, providing adequate functional and aesthetic outcomes with minimal morbidity. They represent a viable alternative to bone flaps in selected cases, especially where oncologic safety and margin concerns predominate. Large prospective studies are warranted to further define indications and long-term outcomes.
Çeçen et al. (Wed,) studied this question.