Submental Island Flap

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Preoperative Considerations


  • Cosmetic changes
  • Limitation of neck movement
  • Numbness & paralysis


  • Oral or nasal tube depending on area to be reconstructed
  • Paralysis per surgeon preference if stimulating
  • Supine


  • None


  • #15/10 blade
  • Monopolar/bipolar electrocautery
  • Skin hooks
  • Debakey
  • Harmonic scalpel
  • Skin hooks
  • Nerve tester
  • Allis clamp
  • Vascular Clips (S,M,L)
  • Lone Star
  • 2-0 Vicryl
  • Skin sutures


Postoperative Considerations


  • Optimize nutrition
  • SLP
  • PT consult

Follow Up:

  • Physical therapy

Operative Note

Surgeon(s): ***

Assistant Surgeon(s):  ***

Preoperative Diagnosis: ***

Postoperative Diagnosis: Same

Procedure(s): Submental Island Flap

Anesthesia: General

Implants: None


Drains: None

Fluids: See anesthesia record

EBL: Minimal

Complications: None

Counts:  Correct x2

Indications: ​***

Findings: As expected

Procedure in Detail:

The patient was seen in the preoperative holding area with a H&P was updated, consents were verified, surgical site marked, and all questions and concerns related to the proposed procedure were discussed in detail.  The patient was transferred to the operating room by the anesthesia team.  The patient underwent general anesthesia with endotracheal intubation. Tegaderms were placed over the eyes. The patient was prepped and draped in the standard fashion for maxillofacial procedures.  A time-out was performed and the procedure began.

A curvilinear incision was made along the anterior border of the submental region, extending from the midline to the anterior border of the sternocleidomastoid muscle bilaterally. Dissection was carried out meticulously through the subcutaneous tissue, platysma muscle, and superficial cervical fascia, exposing the submental artery and vein. Careful preservation of the vascular pedicle was ensured to maintain adequate blood supply to the flap. The submental island flap was then designed and harvested, incorporating adequate subcutaneous tissue to address the defect site. The flap was dissected off the underlying submental muscles, ensuring preservation of the neurovascular structures. Hemostasis was meticulously achieved, and the flap was transferred to the defect site. Inset of the flap was performed with meticulous attention to detail, ensuring proper orientation and alignment. The flap was secured in place using interrupted sutures, and meticulous closure of the donor site was performed. Hemostasis was confirmed, and a closed suction drain was placed at the donor site. The surgical field was irrigated with saline, and meticulous hemostasis was achieved. The wound was closed in layers

The patient's face was then cleaned and the posterior pharynx was suctioned. An OG tube was used to suction out the contents of the stomach. Tegaderms were removed from the eyes. Dressings were placed. The patient was then transferred back to the care of the anesthesia team for extubation and recovery.


  • 15732 - Flap with muscle and cutaneous defect (e.g., radial forearm flap) - This code may be used if the submental island flap includes muscle tissue.
  • 15734 - Free, with microvascular anastomosis - If the submental island flap is harvested as a free flap and requires microvascular anastomosis.
  • 15738 - Microvascular transfer of tissue, muscle, and/or vascularized tissue, including anastomosis - This code may be used for the microvascular transfer portion of the procedure.
  • 15756 - Muscle, myocutaneous, or fasciocutaneous flap; head and neck (e.g., temporalis, masseter, sternocleidomastoid, sternohyoid, thyrohyoid, platysma, anterior, or posterior digastric, other specified muscle or muscle group) - If the submental island flap includes muscle tissue and is used for head and neck reconstruction.
  • 20955 - Unlisted procedure, musculoskeletal system, general - If none of the above codes accurately describe the procedure performed.