Reconstruction of the Cheek after Large Port-Wine Stain Lesion Resection

A laser is commonly used in treatment of port-wine stain (PWS). Although observable lightening of the stains can be achieved, complete removal is rare. A significant proportion of lesions are resistant to laser treatment, including hypertrophic lesions and scars developed after improper (unsuccessful) treatments. Alternatively, resection is used to eliminate such lesions, but the reconstruction of the aesthetic appearance of the cheek after large lesion resection remains a huge challenge. Ten patients with a PWS larger than two-thirds of the cheek were selected for this study. In those patients, prefabricated induced expanded flaps carried by the superficial temporal vessels were prepared to cover the defect areas after resection of the PWS lesion. In eight patients, all the donor sites and defect areas were covered primarily with the expanded flaps, which then survived completely. All patients were satisfied with the cheek appearance after reconstruction with prefabricated induced expanded flaps, which provided a good match for color and texture, restored facial contour, placed scars in a concealed location, and achieved minimal donor-site morbidity. Two of the ten patients did not finish the original surgical plan due to infection or damage to the vascular pedicle. We show that the technique of using prefabricated expanded flaps based on the superficial temporal vessels can be an effective option for repairing large cheek defects after PWS resection.