Pediatric facial free flaps.

Facial soft tissue deficiency in children has components of both congenital and apparently acquired processes, such as craniofacial microsomia, facial clefts, and Romberg's hemifacial atrophy. Correction of these deficiencies has traditionally been delayed until completion of dentoskeletal reconstructions, facial growth, or the disease process. However, there is a trend toward ever earlier correction of these soft tissue deformities, as part of a general effort to minimize psychological trauma. Microvascular free flap augmentation seems to have replaced dermofat sandwich grafts and alloplastic materials as the method of choice for correction of soft tissue defects. The choices of donor site, recipient vessels, and the optimal age for reconstruction of pediatric facial defects are still undefined. In order to examine these variables a retrospective study of the microvascular free flaps that the authors have used was undertaken.