The ZIP Flap Technique
Zygomatic Implant Perforated Flap
A groundbreaking approach to maxillary reconstruction combining immediate surgical reconstruction of the palate with a soft tissue free flap together with rapid fixed dental rehabilitation supported by zygomatic implants following low-level maxillectomy for malignant disease.
Worldwide Published Statistics
Based on 3 published original research studies
About the Inventor
Professor Chris Butterworth developed the ZIP Flap technique at the Liverpool Head & Neck Centre.
FDS (Rest Dent) RCS (Eng),
FDSRCS(Edin) ad-hominem.
Leading International Expert in Maxillofacial Rehabilitation
Professor Chris Butterworth is a Consultant Maxillofacial Prosthodontist based at the Liverpool Head & Neck Centre, one of Europe's largest Head & Neck Cancer centres. Since his appointment in 2003, he has built an international reputation for innovative care in oral and facial rehabilitation.
As the inventor of the Zygomatic Implant Perforated (ZIP) Flap technique, Professor Butterworth has pioneered the combination of skeletally anchored zygomatic implants with microvascular free flap reconstruction for patients with maxillary and mid-facial malignant diseases.
Professor Butterworth is Honorary Professor in Maxillofacial Prosthodontics at the University of Liverpool, Associate Postgraduate Dental Dean for NHS England North West, and Past President of the British Society of Prosthodontics (the youngest ever to hold this position).
Recognition & Awards
- Best Oral Clinical Research Presentation, Academy of Osseointegration 2017, Orlando
- Schottlander Prize, British Society of Prosthodontics 2018
- Fellowship ad-hominem 2024, Royal College of Surgeons of Edinburgh
- Author of over 90 scientific papers and textbook chapters
- Lead author of UK restorative guidelines for head & neck cancer patients
The ZIP Flap Technique
An innovative surgical approach combining microvascular reconstruction with immediate implant-based rehabilitation
What is the ZIP Flap?
The Zygomatic Implant Perforated (ZIP) Flap technique involves the use of a zygomatic oncology implant perforated micro-vascular soft tissue flap for the primary management of maxillary malignancy.
- Immediate surgical reconstruction
- Microvascular free flap closure
- Zygomatic implant placement through flap
- Early loading protocol (3-6 weeks)
- Fixed dental prosthesis delivery
Key Benefits
- Rapid return to function within weeks
- Excellent autogenous oronasal seal
- Immediate cortically anchored support
- Compatible with adjuvant radiotherapy
- Superior quality of life outcomes
- Predictable, reproducible results
Clinical Outcomes
Published results from 35 consecutively treated patients demonstrate:
- 100% vascularized flap survival
- 98.4% zygomatic implant survival
- 97% prosthesis survival
- Median 29 days to prosthesis fitting
- Highly rated by patient-reported outcomes
Ideal Indications
- Low-level maxillary malignancy (Brown Class II)
- Squamous cell carcinoma of hard palate
- Maxillary alveolar tumours
- Cases requiring adjuvant radiotherapy
- Patients requiring rapid rehabilitation
- Infrastructure maxillectomy defects
Latest Updates from ZIP Flap Network
Recent case reports and news from our global network
