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Outcomes showed major complications in 5 flaps with partial necrosis and dehiscence as the most frequent events, and no total flap loss.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/evolution-of-cervicofacial-flaps-freestyle-multiperforator-island-flap-cost-effective-facial-reconstruction-study/432152/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/evolution-of-cervicofacial-flaps-freestyle-multiperforator-island-flap-cost-effective-facial-reconstruction-study/432152.png","ImageObject",300,407,{"name":42,"@type":43},"Dipper","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-01","2026-09-29",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",13,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What is the Freestyle Multiperforator Island Flap (FMIF)?","Question",{"text":63,"@type":64},"FMIF is a subcutaneously based island flap concept customized in location and size for facial reconstruction. 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Partial necrosis and dehiscence were the most frequent complications, each at 5.4%, with no total flap loss reported.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},432152,1790695242,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":124,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":145,"preview_page_count":4},1374404997633,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","JPRAS Open 48 (2026) 321–330  \nContents lists available at ScienceDirect  \nJPRAS Open  \njournal [homepage:](homepage: www.elsevier.com/locate/jpra)[ www.elsevier.com/locate/jpra](homepage: www.elsevier.com/locate/jpra)  \nOriginal Article  \nEvolution of cervicofacial flaps: From classical reconstruction to Freestyle Multiperforator Island Flap  \nOswaldo J. Gómeza,b,c, Carlos E. Ruiz a,b,∗, Erika Padilla b, Andrés F. Patiñob  \na Plastic Surgery Unit, Universidad Nacional de Colombia, Bogotá, Colombia b Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia c Plastic Surgery Unit, National University Hospital of Colombia, Bogotá, Colombia  \na r t i c l e i n f o  \nArticle history:  \nReceived 28 July 2025  \nAccepted 18 November 2025  \nAvailable online 23 November 2025  \nKeywords:  \nKeystone flap Perforator flaps Surgical sympathectomy Angiotome  \nFacial defects  \nFacial reconstruction  \na b s t r a c t  \nBackground: This study presents a cost-effective and safe alternative for facial reconstruction, introducing the concept of the Freestyle Multiperforator Island Flap (FMIF) a subcutaneously based flap that can be customized in both location and size. Its versatility stems from the extensive vascular cutaneous territories supplied by the dermal and facial plexuses, which branch in an arborescent pattern to ensure reliable perfusion across multiple facial regions. Methods: A retrospective case series of 34 patients (37 flaps) with cheek defects treated between 2012 and 2022 is presented. Demographic profiles, defect etiology, flap characteristics, and postoperative outcomes were analyzed.  \nResults: A total of 37 flaps were performed in 34 patients. The most common etiology was malignant tumors (83.7 %), squamous cell carcinoma (43.2 %), basal cell carcinoma (29.7 %), and melanoma (10.8 %), followed by benign tumors (10.8 %) and others (5.4 %).  \nTwenty-five flaps were used for the reconstruction of the parotidmasseteric subunit, with 54 % designed at a flap-to-defect ratio ranging from 5:1 to 10:1.  \nIn 29 flaps (78.37 %), the average pedicle area was 16.2 %(range: 10 %–20 %).  \n∗ Corresponding author.  \nE-mail addresses: [ojgomezd@unal.edu.co](ojgomezd@unal.edu.co) (O.J. Gómez), [ceruizm@unal.edu.co](ceruizm@unal.edu.co) (C.E. Ruiz).  \n[https://doi.org/10.1016/j.jpra.2025.11.026](https://doi.org/10.1016/j.jpra.2025.11.026)  \n2352-5878/© 2025 The Authors. Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons. This is an open access article under the CC BY-NC-ND license  \n([http://creativecommons.org/licenses/by-nc-nd/4.0/](http://creativecommons.org/licenses/by-nc-nd/4.0/))  \nO.J. Gómez, C.E. Ruiz, E. Padilla et al. JPRAS Open 48 (2026) 321–330  \nRegarding outcomes, major complications occurred in five flaps, with partial necrosis and dehiscence being the most frequent (5.4 % each). No total flap loss was reported.  \nConclusions: The FMIF offers a safe, versatile, and cost-conscious option for facial reconstruction, providing reliable perfusion and minimal donor-site morbidity through its adaptable pedicle design. Although early outcomes are favorable, the absence of a control group limits definitive conclusions. Future comparative and anatomical studies are required to validate its vascular basis, safety, and role alongside established reconstructive techniques.  \n© 2025 The Authors. Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons. This is an open access article under the CC BY-NC-ND license  \n([http://creativecommons.org/licenses/by-nc-nd/4.0/](http://creativecommons.org/licenses/by-nc-nd/4.0/))  \nIntroduction  \nFacial reconstruction requires high aesthetic and functional standards, ideally achieved through cost-effective, reproducible, and safe techniques. These techniques should adhere to the principles of complete facial subunit replacement and the “like-to-like” effect, ensuring acceptable aesthetic outcomes wi","cbCaibGENJAV4tuS","https://ap.wps.com/l/cbCaibGENJAV4tuS","pdf",1513899,"English","# Introduction\n## Design and vascular principles of FMIF\n## Random physiological pedicles and pedicle area concept\n# Methods\n# Results\n## Etiology and defect reconstruction targets\n## Pedicle area and postoperative outcomes\n# Conclusions","[{\"question\":\"What is the Freestyle Multiperforator Island Flap (FMIF)?\",\"answer\":\"FMIF is a subcutaneously based island flap concept customized in location and size for facial reconstruction. It relies on extensive vascular cutaneous territories supplied by dermal and facial plexuses.\"},{\"question\":\"How were facial cheek defects evaluated in the study?\",\"answer\":\"The study is a retrospective case series of 34 patients with 37 flaps treated between 2012 and 2022. Demographic profiles, defect etiology, flap characteristics, and postoperative outcomes were analyzed.\"},{\"question\":\"What were the main postoperative complication findings?\",\"answer\":\"Major complications occurred in five flaps. Partial necrosis and dehiscence were the most frequent complications, each at 5.4%, with no total flap loss reported.\"}]","Evolution of cervicofacial flaps - Freestyle Multiperforator Island Flap - cost-effective facial reconstruction study | PDF",1790658296,25]