Perinasal defects are most commonly caused by tumour extirpation or trauma. There are a number of methods to reconstruct the defect, and the method chosen depends on the size of the defect and other patient considerations. When the defect is located in the central aspect of the face an aesthetic outcome with a single session surgery is preferred. When the defect is small local flaps are successful, however options are more limited for larger defects. The authors describe a flap pedicled on the superficial musculoaponeurotic system. This is useful for reconstruction of the nasal tip, supratip, lateral nasal margin and infraorbital area. They describe a series of 17 patients, 12 female and five male. The flap is designed on sound principles as the anatomy of the SMAS and the blood supply to the area is well discussed. Additional photographs outline the results. There are limitations in terms of size and scarring, so this flap is possibly best used in the elderly patient. This is a good flap to have in the facial surgeon’s armamentarium and is also a good flap for patients with previous surgery or trauma precluding using a forehead flap.
A new flap for the perinasal region
Reviewed by Sunil Kumar Bhatia
Propeller facial artery perforator flap as first reconstructive option for nasolabial and perinasal complex defects.
