Reconstruction of Midface Defects with the Facial Artery Perforator Flap: A Review of the Literature

Abstract

Objective: Defects of the nasal, perinasal, and infraorbital areas usually develop after trauma or tumoral excision. The key points of reconstruction of these areas are achieving a good color match and tissue compatibility, avoiding or minimizing functional deficits, and preventing disfigurement in the surrounding tissue. This study is a review of midfacial defects reconstructed with a facial artery perforator flap. Methods: Nineteen patients were operated on for midfacial tumoral masses between 2008-2017. After excision of the lesion with the appropriate surgical margins, the resulting defects were reconstructed with facial artery perforator flaps. Recovering the anatomical and functional structure of the area or avoiding deterioration was the goal. In order to avoid ectropion, flaps were anchored to the periosteum when the lower eyelid was involved. All flap donor sites were primarily repaired. Results: In 1 patient, venous insufficiency was observed, and in another, hematoma and ecchymosis developed, but flap failure did not occur. A trap door deformity was observed in 2 flaps. The patients were satisfied with the aesthetic and functional outcomes. Conclusion: The facial artery perforator flap is a good option for reconstruction of midface defects because it is elevated in a single stage, it provides freedom to design and transfer, and the donor site can be primarily closed.

Keywords

• facial artery
• midface
• perforator flap.