The Facial Artery Perforator Flap for Reconstruction of Perioral Defects

Stefan O. P. Hofer, Nicole A. Posch, Xander Smit
2005 Plastic and Reconstructive Surgery  
The concept of the facial artery perforator flap was developed to gain more freedom for reconstruction of perioral defects. Single perforators of the facial artery should supply a large area of facial skin for a pedicled perforator flap. Methods: Five fresh cadavers yielding 10 facial arteries were dissected after Microfil vascular injection to study distribution, number, length, and diameter of facial artery perforators. Five clinical cases with cancer-related perioral defects were
more » ... ts were reconstructed with facial artery perforator flaps. In two cases, additional regional flaps were used. Surgical technique was governed by the aesthetic unit principle and Doppler identification of the facial artery, which was used as a guideline for identification of suitable facial artery perforators. Results: Cadaver dissection showed a large number of evenly distributed facial artery perforators (average, 5.7; range, three to nine). The average perforator length was 25.2 mm (range, 13 to 51 mm). The average perforator diameter was 1.2 mm (range, 0.6 to 1.8 mm). In all clinical cases, a suitable facial artery perforator was identified to meet reconstructive demands. Flaps were rotated up to 180 degrees. Four flaps survived completely. One flap showed minor distal necrosis. Conclusions: The facial artery perforator flap offers a versatile tailor-made flap, because of the reliable presence of
doi:10.1097/01.prs.0000154208.67390.5c pmid:15793435 fatcat:ojwuslsdbvbxzoz2gothiiduxy