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BackgroundVarious techniques such as free tissue transfer,flap prefabrication,andtissue expansion have been combined in order to achieve the best aestheticresults for facial soft tissue resurfacing.However,the search for the idealdonor-site having similar characteristics in terms of texture,pliability andcolour with the skin of the recipient area still remains a great challenge.Methods36 patients presenting head and neck defects with different size were treatedwith flaps harvested from the neck,supraclavicular,anterior chest,lateralchest and scapular areas.The aesthetic and functional post-operativeoutcomes were analysed and compared.Results17 male and 19 female patients underwent successful facial soft tissueresurfacing with different surgical techniques including free or pedicledtissue transfer,pre-expansion,prefabrication or a combination of these threemethods.The mean age was 23 years,the mean follow-up of 1.5 years.Allflaps survived completely after transfer,and no major complication wasobserved.ConclusionsWe hereby present our current concept of “S & S” (similarity & subunits)principle for facial soft tissue resurfacing that takes into account the skinsimilarity of the donor -site to the defect area and the subunits of the face forthe plan of the reconstruction.