Aesthetic Plastic Surgery

, Volume 36, Issue 1, pp 163–168 | Cite as

Principles of Hatchet-Skin Flap for Repair of Tissue Defects on the Cheek

  • Wang Zhi-guo
  • Xu Quan-chen
  • Kuang Rui-xia
  • Chen Zhen-yu
  • Huo RanEmail author
Original Article



To date, cheek reconstruction remains a challenge for plastic surgeons. This report presents the authors’ cheek reconstruction technique with different types of hatchet-skin flaps, which provides satisfactory results.


The cheek area was divided into three parts (P1, P2, and P3), with vertical lines passing through the medial and lateral canthus. Different types of hatchet-skin flaps were used to repair the tissue defects in each part. The study population consisted of 29 patients divided into three groups according to the location of the defect (G1, G2, and G3). Patient satisfaction was evaluated 1 year after the operation using a questionnaire concerning five important aspects: color match, texture match, scar visibility, morbidity, and function.


The 29 patients (17 men and 12 women) ranged in age from 19 to 81 years. The sizes of the defects ranged from 1.5 × 1.5 to 2.5 × 3.5 cm. All the flaps survived. The patients’ ages and defect sizes did not differ between the three groups. The mean rating of each evaluation was high in all three groups. The mean rating for scar visibility on a 5-point scale was significantly lower for G1 than for G3.


The hatchet-skin flap procedure is a versatile technique for the repair of medium defects in the three parts of the cheek. The defects in each part of the cheek should be repaired separately depending on the characteristics of the natural lines.


Cheek reconstruction Hatchet-skin flap Tissue defect 


  1. 1.
    Bakamjian VY (1965) A two-stage method for pharyngoesophageal reconstruction with a primary pectoral skin flap. Plast Reconstr Surg 36:173–184PubMedCrossRefGoogle Scholar
  2. 2.
    Maths SJ, Vasconez LO (1978) The cervicohumeral flap. Plast Reconstr Surg 61:7–12CrossRefGoogle Scholar
  3. 3.
    Ariyan S (1979) The pectoralis major myocutanoeous flap, a versatile flap for reconstruction in the head and neck. Plast Reconstr Surg 63:73–81PubMedCrossRefGoogle Scholar
  4. 4.
    Baek SM, Biller HF, Krespi YP, Lawson W (1980) The lower trapezius island myocutaneous flap. Ann Plast Surg 5:108–114PubMedCrossRefGoogle Scholar
  5. 5.
    Freedman AM, Hidalgo DA (1990) Full-thickness cheek and lip reconstruction with the radial forearm free flap. Ann Plast Surg 25:287–294PubMedCrossRefGoogle Scholar
  6. 6.
    Emmett AJ (1977) The closure of defects by using adjacent triangular flaps with subcutaneous pedicles. Plast Reconstr Surg 59:45–52PubMedCrossRefGoogle Scholar
  7. 7.
    Reynaud JP (1983) Hatchet flap for the repair of cutaneous excisions on the nose. A propos of 30 cases. Ann Chir Plast Esthet 28:369–375PubMedGoogle Scholar
  8. 8.
    Horwath H, Roscic Z, Falkensammer G et al (1989) Hatchet-form flap as a method of esthetic reconstruction of the nose. Fortschr Kiefer Gesichtschir 34:151–153PubMedGoogle Scholar
  9. 9.
    Baron JL, Reynaud JP, Gary-Bobo A et al (1990) Specificity of hatchet flaps in the laterofacial region. Ann Chir Plast Esthet 35:47–52PubMedGoogle Scholar
  10. 10.
    Pan Y, Ai YF, Li HY et al (2004) Local hatchet flap for facial skin defects reconstruction in special areas. Dermatol Surg 30:1256–1260PubMedCrossRefGoogle Scholar
  11. 11.
    Sowerby LJ, Taylor SM, Moore CC (2010) The double-hatchet flap: a workhorse in head and neck local flap reconstruction. Arch Facial Plast Surg 12:198–201PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC and International Society of Aesthetic Plastic Surgery 2011

Authors and Affiliations

  • Wang Zhi-guo
    • 1
    • 2
  • Xu Quan-chen
    • 3
  • Kuang Rui-xia
    • 2
  • Chen Zhen-yu
    • 2
  • Huo Ran
    • 1
    Email author
  1. 1.Department of Burn and Plastic SurgeryShandong Provincial Hospital, Shandong UniversityJinanChina
  2. 2.Department of Burn and Plastic SurgeryAffiliated Hospital of Qingdao University Medical CollegeQingdaoChina
  3. 3.Department of StomatologyAffiliated Hospital of Qingdao University Medical CollegeQingdaoChina

Personalised recommendations