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The evolution of facial artery perforator flap for midface reconstruction with preoperative ultrasound examination

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European Journal of Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Medium and small size defects of the midface are still a surgical reconstructive challenge. Nasolabial flap is a good choice for these cases, but secondary surgeries are usually needed to adapt or debulk the flap. The authors propose preoperative ultrasound examination to design the flap based on a perforator of the facial artery.

Methods

Twenty-one patients who have undergone a midface reconstruction with a facial artery perforator flap were included. Clinical data, surgical outcomes, and complications were collected. Preoperative ultrasound examination was performed in all cases in order to identify a perforator of the facial artery and the final flap was design based on it.

Results

In all cases, a perforator of the facial artery was found using ultrasounds. In all cases, functional and esthetic outcomes were achieved and none of the patients asked for a secondary cosmetic procedure. Complications included partial skin loss of the flaps in two cases and temporary edema in three cases, with no need of a secondary procedure required.

Conclusions

The facial artery perforator flap based on a perforator of the facial artery is safe, versatile, and one-stage alternative to the traditional randomized nasolabial flap in the reconstruction of small-to-moderate–sized facial defects, with adequate functional and esthetic results and low morbidity of the donor site. Preoperative ultrasound examination improves the design of the flap and the selection of the best perforator and reduces the need to skeletonize the perforator; consequently, it reduces postoperative complications and the total surgical time.

Level of evidence: Level IV, Risk/Prognostic.

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Author information

Authors and Affiliations

  1. Department of Plastic Surgery, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, s/n, 08916, CanyetBadalona, Barcelona, Spain

    Paloma Malagón MD, PhD

  2. Chief of Microsurgery Department, HM Delfos, Barcelona, Spain

    Jesús González MD, PhD

Authors
  1. Paloma Malagón MD, PhD
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  2. Jesús González MD, PhD
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Corresponding author

Correspondence to Paloma Malagón MD, PhD.

Ethics declarations

Ethics approval

This study was performed in accordance with the Declaration of Helsinki (1964) and later amendments. This study has received approval by the local Ethical Committee (reference number: JES-ECO-2016–09).

Conflict of interest

Paloma Malagón and Jesús González declare no competing interests.

Funding

none.

Patient consent Informed consent

was obtained from each patient prior surgery for their inclusion in the study and for taking and sharing their images.

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Malagón, P., González, J. The evolution of facial artery perforator flap for midface reconstruction with preoperative ultrasound examination. Eur J Plast Surg 45, 933–939 (2022). https://doi.org/10.1007/s00238-022-01974-x

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  • DOI: https://doi.org/10.1007/s00238-022-01974-x

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