Reconstruction of the perioral and perinasal defects with facial artery perforator flaps

• Published in: Journal of plastic, reconstructive & aesthetic surgery Vol. 62; no. 12; pp. 1616 - 1620
• Main Authors: Demirseren, Mustafa Erol, Afandiyev, Kamran, Ceran, Candemir
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.12.2009; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Carcinoma, Basal Cell - pathology; Carcinoma, Basal Cell - surgery; Esthetics; Face - blood supply; Facial artery; Facial reconstruction; Female; Head and Neck Neoplasms - pathology; Head and Neck Neoplasms - surgery; Humans; Male; Medical sciences; Middle Aged; Mouth Neoplasms - pathology; Mouth Neoplasms - surgery; Nose Neoplasms - pathology; Nose Neoplasms - surgery; Perforator flap; Plastic Surgery; Reconstructive Surgical Procedures - methods; Skin Neoplasms - pathology; Skin Neoplasms - surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgical Flaps - blood supply; Treatment Outcome; Facial reconstruction; Facial artery; Perforator flap; Treatment; Surgery; Free flap; Anatomical reconstruction; Face
• ISSN: 1748-6815; 1878-0539
• DOI: 10.1016/j.bjps.2008.07.037

Summary Perioral and perinasal regions are important aesthetic subunits of the face. Numerous traditional flaps supplied by the facial artery are well known and have widespread use in these regions. Elevation of these flaps based on the perforator branches of the facial artery can make them more mobile, reliable and adaptable. This report presents the authors' experience using a facial artery perforator flap in the reconstruction of perioral and perinasal defects. Twelve clinical cases with 14 perioral and perinasal skin defects resulting from malignant or benign skin tumour excision were reconstructed using facial artery perforator flaps. Surgical technique was planned by adhering, as much as possible, to the principle of aesthetic unit for facial reconstruction. The donor-site scars were designed parallel to the facial wrinkles when possible. As an adjunct procedure, a lower lip buccal mucosal V–Y advancement flap was used in some patients who had defects that included lower lip mucosa. In all cases, favourable cosmetic and functional results were obtained with a single-stage procedure that did not require secondary revisions. The aesthetically pleasing donor site based on the facial artery perforators offers a versatile tailor-made flap, because of the reliable presence of perforators, with a large arc of rotation. The quality of the results obtained using this flap represents a considerable advance in facial reconstruction.