Extended pectoralis major myocutaneous flap in head and neck reconstruction

Figure 1 Flap design and elevation. A: Marking of skin paddle with inferior line representing costal margin; B: Flap being elevated along with rectus sheath (exposed rectus muscle inferiorly).

Figure 2 Reconstruction of large cutaneous defect (Patient 1). A: Large locally invasive thyroid malignancy with skin involvement; B: Post-ablative defect; C: Marking for flap; D: Wound 1 wk after surgery.

Figure 3 Reconstruction of full thickness cheek defect (Patient 3). A: Post-ablative defect; B: Marking for skin paddle; C: Immediate post-reconstruction; D: Two months following surgery.

Figure 4 Reconstruction of large mucosal defect (Patient 4). A: Elevation of flap; B: Two months following surgery.

Figure 5 Reconstruction of large parotid skin defect (Patient 6). A: Tumor parotid with skin involvement; B: Post-ablative defect; C: Skin paddle with marked line representing approximate level of inferior border of pectoralis major muscle; D: Immediately following reconstruction.