Design:
Our institution has over three decades of experience in reconstructing
complex midface defects and this article summarizes midface
reconstruction from an evolutionary perspective (for type II, III and IV
defect; Browns classification, Supplementary table 1 ). We broadly
divide this into (i) flaps supplied by the subscapular system (ii)
autologous reconstruction with titanium mesh and (iii) fibula
microvascular flaps using 3D planning. The advantages and disadvantages
for each approach are discussed (Supplementary Table 2 ).
Conclusion: In the future, it is expected that 3D planning
coupled with rapid prototyping, intraoperative navigation and CT imaging
will become standard procedural practice.