Overview of local flaps of the face for reconstruction of cutaneous malignancies: Single institutional experience of seventy cases

Abstract

Context:The most common malignant tumours of the face are basal cell carcinoma, squamous cell carcinoma and melanoma. While the results of skin graft are less than satisfactory for large areas to cover, distant flaps are bulky with a poor colour match. Local fasciocutaneous flaps provide reasonable option for reconstruction of facial defects with good colour and texture match and good success rate.Aims:This study aimed to analyse the various modalities of reconstruction after resection of facial malignancies and their advantages and disadvantages.Settings and Design:This was a retrospective study.Materials and Methods:Of 70 patients, 34 were managed with V-Y advancement flap, 24 with nasolabial flap, 8 with median forehead flap and 4 with standard forehead flap cover. The duration of follow-up ranged from 6 months to 2 years.Statistical Analysis Used:Nil.Results:Of 34 V-Y advancement flaps, 2 showed suture dehiscence at the apex of triangle which was allowed to heal secondarily with regular dressings. All the 24 nasolabial flaps were healthy without any complication. All patients had satisfactory functional and cosmetic outcomes.Conclusions:In our experience, local flaps give the best results and are the first choice for reconstruction of the face. Most defects can be best closed by nasolabial, V-Y advancement and forehead flap. Outstanding functional and cosmetic results can be achieved. Proper execution requires considerable technical skill and experience.

Reconstruction of Facial Skin Defects by Various Local Flaps in Rural India

“…Similar results were observed in a study by Farooq et al [5] out of 300 cases of cutaneous malignancies studied, the males were 195 (65%) and females were 105 (35%), showing M: F ratio of 1.85: 1. In Rolekar NG et al [6] study males were 20 and females were 10,M:F=2:1.In a study by Rao JK et al [7] males were 45 and females were 25,M:F=1.8:1.…”

“…Rolekar NG et al [6] mean age of presentation of cutaneous malignancies is 55 years. In a study by Rao JK et al [7] mean age of patients with facial malignancies is 61 years. In Ebrahimi A et al [8]study mean age of cutaneous malignancies is 53.02±4.2.…”

Large Basal Cell Carcinoma Defect Closure on The Lateral Cheek Using Multiple Advancement Flaps

“…This technique is also called as U-plasty or rectangular flap due to its design which extends two parallel incision from one side of the surgical defect causing one edge of the defect to become a rectangular shaped advancement flap. (Rohrer et al, 2017, Goldman G, 2012, Rao and Shende, 2016 Advancement flap results in prominent horizontal line, making it an indispensable and more aesthetic tool in many cases of reconstruction of the eyebrow, forehead areas, upper lip and dorsal nose. One of the advantage of this technique is the ability to shift the standing cone to a more favorable location and not necessarily adjacent to the defect.…”

Reconstruction of dorsum of nose after excision of basal cell carcinoma

“…Often, the advancement of the cheek's skin or the nasofacial groove is insufficient to close large nose defects; advancement alone may pull asymmetrically on the nostril or cause a trap-door action. 9 In contrast, rotation of the nasal dorsum, combined with extension of the rotating flap's leading edge, results in a much more aesthetically acceptable result. 10 Classically, a 2 stage paramedian forehead flap is used for closing defects larger than 2.5 cm in diameter on the nasal pyramid; it has a more complex design and is more difficult to execute.…”