Three-dimensional observation of the vasculature in the anterolateral thigh adipofascial flap and its clinical applications

OBJECTIVE: To investigate the blood supply patterns of the anteriorlateral thigh adipofascial flap for clinical applications. METHODS: To investigate the blood supply patterns of the anteriorlateral thigh (ALT) adipofascial flap, 16 fresh cadavers were anatomically examined by intraarterial injection of colored latex. Three-dimensional analysis of the vasculature of the subcutaneous adipofascial tissue was performed. Sixteen patients underwent microsurgical correction with the ALT adipofascial flap. Among them, there were fifteen with hemifacial atrophy, one with micromastia. RESULTS: The three-dimensional arterial structures of the ALT adipofascial flap were the same in all the cadaver specimens. Each layer of the adipofascial tissue was supplied by several blood vessels of the axial pattern, especially in the deep layer. Sixteen patients were successfully treated with this flap. The postoperative follow-up ranged from six months to eleven years. There was not postoperative flap necrosis or absorption of the fatty tissue. Stable restoration of the facial contour or the breast was achieved. The donor-site morbidity was minimal. CONCLUSION: The blood supply of the ALT adipofascial flap is reliable. A considerable amount of the fatty layer of the flap can be removed primarily. It is a preferable procedure for reconstructing soft tissue defects.