Chimeric scapular tip flap for the reconstruction of extensive defects of the midface

Aim: The main aim of the present report was to show the potential utility of scapular tip flap for maxillary reconstruction. Materials and methods: The medical records of 4 patients that had undergone maxillary reconstruction by using a microvascular scapular tip flap in our department were retrospectively reviewed to identify the possible advantages and disadvantages of this type of flap. Aesthetic and functional outcomes were also analyzed. Results: No evidence was found for failures, partial failures, or infection in our series. Scapular tip flap allowed for great aesthetic and functional outcomes. All anastomoses were performed with the facial vessels and there was no need to use arterial or vein graft. No major complications were observed at the donor site during follow-up. Conclusion: Scapular tip flap may be extremely useful in the reconstruction of extensive defect of the midface. Pedicle length, versatility and reliability represent the major advantages of this type of free flap. Moreover, the resistance of the scapular vascular system to atherosclerosis may be helpful in patients showing contraindications to free fibula flaps.