Background: We have performed a mock facial transplantation by harvesting a total facial/scalp flap from the donor and transferring the flap to the recipient cadavers. During the donor flap inset into the created defect in the recipient, the anatomical consideration of the flap anchoring sites, the length of arterial and venous pedicles and nerves incorporated into the facial flaps were evaluated. The sequences and timing of the mock facial transplantation is discussed. Methods: A total of 10 fresh human cadavers were dissected. Seven of the cadavers were female and three were male. The average age of cadavers was 64 years (range, 51 to 91 years). In the donor, we have measured the time of facial-scalp flap harvesting, the length of the arterial and venous pedicles and sensory nerves, which were included in the facial flaps. In the recipient, we have evaluated the time of facial skin harvest as a “monoblock” full-thickness graft, the anchoring regions for the inset of the donor facial flaps and the time sequences for the vascular pedicles anastomoses and nerves coaptations. Results: In the Donor Cadaver the mean harvesting time of the total facial/scalp flap harvest was 235.62±21.94minutes. The mean length of the supraorbital, infraorbital, mental and great auricular nerves was 1.5±0.15, 2.46±0.25, 3.02±0.31 and 6.11±0.42cm, respectively. The mean length of the external carotid artery, facial and external jugular veins was 5±0.32, 3.15±0.32 and 5.78±0.5cm, respectively. In the Recipient Cadaver the mean harvesting time of facial skin as a “monoblock” full-thickness graft was 47.5±3.53minutes. The mean time for the preparation of the arterial and venous pedicles and sensory nerves for the future anastomoses and coaptation was 30±0minutes. The mean time for the facial flap anchoring was 22.5±3.53minutes. The total mean time of facial mock transplantation without vessels and nerves repair was 320±7.07minutes (5hours and 20minutes). Conclusion: Based on anatomical dissections in this cadaver study, we have estimated the time and sequence of the facial flap harvest and inset to mimic the clinical scenario of facial transplantation procedure.

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