Cheek is very special unit of face as all of its boundaries has vital units of face like eye, nose, lip and
ear. Failure to reconstruct cheek will not only affect appearance of cheek but can also affect
appearance of is surrounding units leading to more disfigurement.

Reconstruction of cheek is very important and is required when there is a defect either due to
trauma, infection, birth defects or removal of lesion.

When there is loss of cheek tissue due to trauma, infection, removal of any lesion preset by birth or
after removal of tumor from cheek, it leaves a defect which needs to be filled according to its size
and depth. If not reconstructed properly it causes unsightly scar, depressions, and functional and
cosmetic problems of structures around cheek.

Small defects less than 2 cm can be closed primarily. They are usually moles or skin cancer defects
and are done under local anesthesia as day care procedure.

Large superficial defects can be re surfaced with skin grafts and deep lesion with loco regional flap
or free flap. These surgeries require hospitalization of 4-5 days and more complex defects require
even longer stay and monitoring.

Common flaps used are cheek advancement flap when tissue from lateral cheek is advanced to
cover defect on medial side. Ad cervico-facial flap when tissue from cheek and neck is used for
reconstruction.

Some of the defects of cheek are reconstructed with placement of tissue expander in neck to
achieve more tissue. Tissue expander is like a balloon which is placed under skin in deflated position
and then inflated to expand the tissue and in this way more tissue is achieved for large defects.

FAQ
1. In how many days wounds are healed after reconstruction with flaps?
Wounds are usually healed in 2 weeks
2. When sutures are removed?
Sutures are removed in 5-7 days
3. What is a Cervicofacial flap?
The cervicofacial flap is a rotational and advancement flap with random blood supply utilized to
close moderate- to large-sized defects of the cheek. Subcutaneous dissection of the cervical
region allows for a large amount of tissue mobilization.(copied from google)
4. What are functional problems if cheek not reconstructed?
Cheek is surrounded by eye, ear, nose and ears. If cheek is not reconstructed or not done
properly it will pull lower eyelid down, pull nose towards ear ad lip upward causing functional
problems associated with these vital structures.

Written by : Dr. Fahmina
Copyrights: Pakistan association of Plastic Surgeons