INTRODUCTION:Hemifacial amputation of the soft tissues of the face is a rare form of trauma to the face. Various surgical procedures to reconstruct such injury are various , ranging from local flap to a free tissue transfer.There are certain difficulties associated with such reconstruction based on the fine and complexed anatomical soft tissue structures of the face. This case presentation illustrate the excellent surgical results following left sided facial amputation in a young adult patient utilizing a modiefied DeltoPectoral fasciocutanous flap .

METHODS: A 35 year old pedestrian adult patient was injured by a heavy flying object to his face, a car tire, while attempting to cross a main highway. He sustained severe head concussion with fracture of his left zygoma.The facial structures of his left side of the face were completely amputated as as one unit with exposed mandibular ramus, temporal bone and fossa, avulsion of the left facial nerve, parotid gland, and temporalis muscle as shown in the pictures. However, the amputated part was severely injured, that a re-plantation and revascularization was not indicated. Following initial recovery of the patient after few days, surgical reconstruction of the amputated facial site was reconstructed with a modified Cervico-Delto Pectoral flap based on the left para sternal cutaneous perforators followed by secondary touch up procedures.

RESULTS: The final outcome of the surgical reconstruction was excellent with good maintenance of the facial aesthetics and contour of the left side of the patient face.

CONCLUSION: A modified Cervico-Delto-Pectoral fasciocutanous flap can be utilized for adequate reconstruction for the facial region following soft tissue defects following trauma or tumor resection.