This technical note describes the harvesting and insetting of a chimeric anterolateral thigh (ALT) flap to reconstruct a through and through cheek defect. Two perforators originating from the lateral circumflex femoral system that joined to the same mother vascular source were identified. Two separate skin paddles based on the perforators were designed and appropriately inset to repair the mucosal lining and the cheek skin. Careful harvesting and insetting of the chimeric ALT flap ensures a good cosmetic and reconstructive effect in the reconstruction of the through and through cheek defect.
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