A cervicofacial flap lifts a large sheet of cheek and neck skin and slides it upwards to close a defect on the face. Because the replacement comes from the same region, colour and texture match in a way no graft can.
A cervicofacial flap is a large advancement and rotation flap raised from the cheek and upper neck. Incisions run in front of and around the ear and down into the neck, letting a broad sheet of skin move upwards to fill a cheek defect. Surgeons choose it when a defect is too big for a small local flap.
Cheek skin sits on a fairly loose layer, and the neck below it has spare laxity that most people can afford to lend. A cervicofacial flap makes use of both. The surgeon designs an incision that runs upwards in front of the ear, curves around the earlobe and continues down the side of the neck, then lifts the whole sheet of skin and fat forwards and upwards until it covers the defect on the cheek.
What makes this flap valuable is the match. A graft placed on the cheek tends to look pale, flat and obviously different, whereas advanced cheek skin behaves like the face it came from. Scars fall in the crease in front of the ear and in the hairline, where they are largely hidden, so a large reconstruction can end up looking surprisingly quiet.
Careful attention is paid to the lower eyelid. Any flap that pulls upwards near the eye can drag the lid down as it settles, so the tissue is usually anchored to firm structures at the outer corner and over the cheekbone. Drains are commonly placed, since a large space is created beneath the skin.
This flap suits defects that are large enough to need plenty of skin but still within the reach of the cheek and neck.
The lesion is removed with the margin agreed by surgeon and pathologist. Once the defect is final, its width and height are measured so the flap can be designed to reach without stretch.
A line is drawn in front of the ear, around the lobe and into the neck, following creases and the hairline. Placement here decides how visible the scars will be later.
Skin and fat are lifted as one sheet in a plane that protects the branches of the facial nerve. Dissection continues until the flap moves freely into the defect.
Deep stitches anchor the flap to firm tissue at the cheekbone and the outer corner of the eye. That takes tension off the lower lid before the skin edges are closed.
A drain is usually left under the flap for a day or two. A light supportive dressing steadies the area and reduces bruising.
Swelling and bruising of the cheek and neck are at their peak. The drain comes out once output falls, and pain is usually moderate.
Sutures are removed and swelling starts to settle. Numbness across the cheek is normal at this point and can be quite extensive.
Scars look pink but are flattening, and most facial movement feels normal. Any minor pull on the lower lid is reassessed now.
Colour evens out and the scars pale. Sensation returns gradually over many months and may not come back everywhere.
Colour and texture usually blend well, and from normal conversational distance most reconstructions look unremarkable. Scars in front of the ear stay visible on close inspection and take many months to pale. Numbness over the cheek is expected early and may persist in patches. Slight unevenness of the cheek or the lower eyelid can remain, and a small revision is sometimes needed later.
Raising a large flap on the face carries specific risks, and they are worth understanding before consenting.
Donor and recipient areas form one large wound running from the neck up to the cheek, so the whole field is cared for together.
Grafts on the cheek often look pale and sunken. Advanced cheek skin keeps facial colour and contour, which is why a flap is preferred for larger defects.
Incisions sit in front of the ear, around the lobe and in the neck and hairline, where natural creases hide most of the line.
The flap is raised in a plane above the nerve branches. Weakness is uncommon, and when it does occur it is usually temporary.
Small sensory nerves in the skin are unavoidably divided when a large flap is raised. Feeling returns slowly over months as those fibres regrow.
Elegance Clinic in Surat plans facial reconstruction around both appearance and function, and Dr. Ashutosh Shah discusses graft and flap options together so patients can weigh scar position against colour match.
This page describes a technique, so it does not carry its own price. A cervicofacial flap is one way of closing a cheek defect, and cost depends on the treatment it is used within, the size of the excision, anaesthesia and the length of hospital stay.
Indicative bands sit on the relevant treatment pages, and a written estimate follows examination so there are no surprises at admission.
These are the questions that come up most often in consultation. If yours is not here, send it on WhatsApp and the team will reply, usually the same day.
Ask your question →A technique carries no price of its own. The total depends on the treatment it forms part of, the size of the defect, theatre time, anaesthesia and stay. After examination a written estimate is prepared so families can plan.
For fit patients it is a dependable procedure. Recognised risks are breakdown at the leading edge, bleeding under the flap, temporary facial nerve weakness and pull on the lower eyelid. Stopping smoking lowers several of these.
Drains come out within a day or two and sutures at about a week to ten days. Most people manage office work at two to three weeks. Swelling and numbness settle over several months.
Lines sit in front of the ear, around the lobe and in the neck and hairline. They are visible on close inspection and pale slowly over a year. Sun protection helps them fade more evenly.
Patients with irradiated or heavily scarred neck skin, those who continue smoking, and those whose defect goes through the full thickness of the cheek usually need a different reconstruction.
It can, which is why the flap is anchored deeply at the outer corner during surgery. Should mild sagging appear, it often improves as swelling settles, and a small correction is possible later.
The lesion or defect is examined, cheek and neck laxity is tested, and eyelid position is checked. Your health, medicines and smoking history are reviewed, photographs are taken, and options are compared before a date is set.
Seeing patients from across the city and beyond: read about the practice on the plastic surgeon in Surat page, or check what a written estimate covers on the costs and insurance page.
