Introduction: The superficial inferior epigastric artery flap offers ample volume for reconstruction, an inconspicuous scar, and no functional donor site deficit. This report details its use for volume replacement after parotidectomy. Methods: We report a 27-year-old woman with recurrent acinic cell carcinoma, requiring left total parotidectomy and partial mastoidectomy. In anticipation of significant contour deficit and postoperative radiation, reconstruction with a superficial inferior epigastric artery adipose-free flap was performed. Results: Resection and reconstruction were carried out with no complications. The postoperative course was uneventful, with recovery of facial nerve function and an aesthetic, symmetrical outcome. The donor site scar is completely hidden by underwear. Conclusion: The superficial inferior epigastric artery flap represents an underused option in head and neck reconstruction. It offers similar benefits to that of the parascapular flap but with the advantages of a 2-team approach and a less conspicuous donor scar.
Keywords: facial asymmetry; free flap; microsurgery; parotidectomy.