Facial contour reconstruction with free flaps.

Augmentation of facial soft tissues is frequently required in Romberg's disease, lateral facial dysplasia, lipodystrophy, and following tumor resections. The buried deepithelialized free groin flap provides a satisfactory solution to this problem. Technical refinements have ensured the survival of the flap and the sophistication of the contour correction. These refinements are a careful analysis of the defect, appropriate contouring prior to revascularization of the flap, slight over-correction of the eyelid defect, and a submandibular incision for improved exposure. The groin flap provides the soft, natural reconstruction desired by the patient. All patients with Romberg's disease maintained the bulk of their reconstructions.