Primary reconstruction following total maxillectomy to maintain the facial contour

Maxillary reconstruction after ablative surgery has long been a challenge for plastic surgeons. The goal of this reconstructive field is to maintain the midfacial contour aesthetic contour and functional units of the orbit, nose, paranasal sinuses, and upper dental arch. In order to obtain satisfactory results, several complicated procedures including vascularized bone grafts, transferring several flaps, and prolonged operative times have been reported. However, the prognosis of the patients with large maxillary defects that require immediate reconstruction reviewed in this article is poor. Therefore in primary reconstruction for total maxillectomy, shortening the operative times, reducing the early postoperative complications, maintaining the speech and swallowing functions, and finally preventing severe facial deformities are important principles. In this paper, we describe simple reconstruction such as those using the single flap procedures including palatine-naso-facial portion (PNF) methods and titanium mesh. For edentulous patients, we developed slit-type maxillary reconstruction for patients who undergo total or extended maxillectomy.