Facial reconstructive surgery.

Reconstruction of facial defects can be very challenging, even in the hands of an experienced surgeon. Most defects can be repaired using local available tissues. Lip defects can be reconstructed using geometric closure techniques and advancement of local tissues. Forehead defects can be reconstructed using skin grafts, caudal auricular flaps, or rotational or transposition flaps. Care must be taken to minimize tension on eyelids and maintain the integrity of the facial nerve. Cheek defects can be reconstructed using local advancement, superficial temporal, omocervical, and caudal auricular flaps. The bridge of the nose can be very difficult to reconstruct due to a paucity of local tissues; however, skin grafts, indirect pedicle flaps, and superficial temporal flaps can be considered. .