The versatile melolabial flap

Abstract

The melolabial flap is a versatile technique for reconstruction of defects of the central face. Variations of this flap may be used to reconstruct the lower eyelids, the nose, the upper and lower lip, chin, and malar regions. Regional anatomy, indications, technical considerations, and avoidance of complications are discussed on the basis of 10 bilateral cadaver dissections of the melolabial area, in conjunction with 70 reconstructive cases that used this flap. Statistical analysis of the results reveals that flap viability is compromised by previous radiation and smoking. Consequently, alternate methods of reconstruction of the central face should be used in patients who have a history of these problems.

The Platysma Myocutaneous Flap: Underused Alternative for Head and Neck Reconstruction

“…This factor has been invoked as a risk factor for flap survival. 12 In the current series, a recent history of smoking did not portend an increased risk of flap skin loss (Table III).…”

Nasal alar reconstruction: A critical analysis using melolabial island and paramedian forehead flaps

“…Advocates of the paramedian forehead flap support its use when the defect involves greater than several centimeters squared of skin 2,3 or has a vertical orientation 4 . Application has also been favored in patients with a shallow melolabial sulcal depth or at high risk for flap‐related complications 5 (i.e., smokers, diabetics, history of irradiation). Other authors believe the paramedian flap is a second choice to the melolabial flap because it possesses thicker, more rigid tissue qualities, which do not contract significantly and mimic the convex surface of a nasal ala 6,7 .…”

49 Local and Regional Cutaneous Flaps

“…22 It can be transposed as either an interpolated flap requiring subsequent pedicle division or a single-stage transposition flap. The flap is primarily based on the angular artery off the facial artery.…”