Angular artery perforator-based transposition flap for the reconstruction of midface defect

Abstract

Background Midface defect is often seen due to trauma, neoplasm, and infection. It is important to avoid tension and distortion of the local structures and to provide skin color and texture match. We present the technique of angular artery perforator-based transposition flap for small to moderate size defect of the midface. Materials and methods Between 2002 and 2009, 17 patients underwent operations for the reconstruction of midface defect. After tumor excision, perforators were found at the medial aspect of the defect along the nasolabial fold. Considering the change of the defect shape and primary closure of the donor site, the width and length of the flap was determined. The flap elevated disto-proximally and transposed to the defect without tension. The donor site was closed first with partial undermining. Results Besides one patient with partial wound dehiscence of the donor site, all the flaps healed uneventfully. The patients were satisfied with the final result esthetically and functionally. Conclusion The angular artery perforator-based transposition flap takes advantage of the nasolabial flap and perforator flap, and it is a simple and fast procedure. Therefore, it may be an alternative for the reconstruction of midface defect.