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Background Repairing the defects of face and neck remains a big challenge for plastic surgeons. Here we present a case series of pre-expanded cervico-acromial flaps in the repair of soft tissue defects. Method This is a retrospective study that a total of 126 patients between 2001 and 2019 were included. One patient was excluded since he did not complete the treatment. All patients were followed for at least 0.5 years (range: 0.5-4 years, mean 2.50 years) after surgery. Results All patients are satisfied with the appearance. The color and texture of expanded flaps were similar to surroundings. One patient (0.8%) had complete necrosis and received skin grafts. The size of cervico-acromial was 26-10 × 14-6 cm (mean, 15.389 ± 2.701× 8.341 ± 1.075 cm). The time of operation during stage 1 was 59.254 ± 9.895 minutes, 96.912 ± 18.936 minutes during stage 2, and 38.146 ± 9.478 minutes during stage 3. Surgical complication rate was 14.3%, given that 18 patients had complications following the surgery. Conclusions The cercico-acromial flap is a reliable and multifunctional method for face, neck, and chest reconstruction.

Background Port wine stain (PWS) is a congenital benign vascular malformation. Laser treatment is the main therapy for PWS. But some patients are not sensitive to it, and failed laser treatment will leave scars on face. Hence in this study, the authors used prefabricated flap carried by superficial temporal artery to treat PWS. Methods Nine patients diagnosed with large-scaled PWS (occupying more than half of the cheek) from January 2008 to December 2017 were selected in the study. One of them did not finish the treatment. Eight patients completed all scheduled treatments. In the first stage, superficial temporal vessels were transferred to the donor site and then an expander was implanted. About 80 to 150 days later, PWS was removed and the prefabricated flap was used to repair the wound. All the 8 patients were followed-up for 10 months to 36 months. Results Prefabricated flap survived well. All patients are satisfied with the appearance. The color and texture of prefabricated flap is similar to the surroundings. Conclusion The combination of prefabricated flap and skin soft tissue expander not only extends the scale of flap but also enhances the efficacy of surgical treatment. It is a good candidate to treat PWS.

Extensive scarring and giant nevi on the mid and lower faces places further demands on scar resurfacing in terms of match, size, and thickness. The area of supraclavicular cervical flap is rather limited, but the expansion could expand its utility in facial resurfacing.Rectangular expanders were inserted via the incisions at the upper fringes of clavicles, and implanted under supraclavicular flap areas. After full expansion, the flap based on supraclavicular artery was elevated to cover the defects left by surgical removal of scar or tumor. Pedicle division was performed on the 10 to 14 days postoperatively.A total of 17 patients were treated with the described technique between 2005 and 2015. The dimensions of the flap ranged from 17 cm × 8.5 cm to 22 cm × 12 cm. The average size was 197 cm. Twenty-one flaps (with 4 patients in bilateral fashion) survived completely. Epidermolysis occurred to 2 flaps, which healed by conservative management. These flaps matched well with the face in terms of the color, thickness, and texture. No obvious flap shrinkage occurred in the follow-up. The donor sites were closed primarily without loss of function or breast deformity.It is an efficient and safe method to obtain preexpanded supraclavicular flap, applying to patients with extensive scarring on mid and lower faces, especially female ones. Excellent aesthetics can be achieved without compromising function and aesthetics of donor sites.