Arrangement of the blood supply ie, random versus axial. Rotation flaps provide the ability to mobilize large areas of tissue with a wide vascular base for reconstruction. Cheek rotation flap mobilized in a clockwise direction to close a defect creates redundant skin below the eyelashes, which was resected to avoid a standing cone deformity. Insetting of an inferiorly based melolabial flap and closure of the donor site. Arterioles from the terminal vessels of the direct cutaneous, musculocutaneous, or septocutaneous systems run in the subcutaneous layer and then branch into the terminal arterioles supplying the subdermal plexus.
Facial Plastic Surgery Flap Reconstruction Dissection Course
These flaps are generally limited to the lateral aspect of the cheek and to the superior aspect of the cheek near the lower eyelid. Efforts for simplifying the classification of local flaps according to sliding or lifting tissue movements are applauded; however, for teaching purposes, the authors prefer to classify local flaps according to classic transfer methods. The folded trapezius flap for through-and-through cheek defects. Among 13 hypertensive patients with free flap reconstructions in our hospital, two Examples are the nose, eyelids, cheeks and temples see Figure 2. Two additional tests often used to assess viability are capillary refill and warmth.
Rotation Flap - Facial Plastic Surgery - European Medical Alliance
The perioral skin meets the deep red color of the vermilion at the red line. Although numerous methods can be used, they all have their own limitations. Surgeons can use this flap to close temporozygomatic wounds with excellent functional and cosmetic results. Although axial flaps e. If necessary, a skin triangle is excised over the secondary defect -.
In a sense, they are the simplest method of providing soft tissue coverage for the protection of deeper vital structures, such as the facial nerve, mandible, and carotid artery. Vermilion mucosal defects may be repaired with mucosal advancement; however, if the vermilion defect is thick, involving submucosal tissues, then a more substantial musculomucosal tongue or cheek flap is preferred. The philtrum, above the midline of the upper lip, is defined by vertical raised skin prominences forming the philtral columns and the portion of the white line inferiorly forming a gentle curve known as Cupid's bow. Primary closure of defects involving up to one-half of the lip is possible in selected patients with significant lip laxity. Rotation flaps provide the ability to mobilize large areas of tissue with a wide vascular base for reconstruction. Rotation flap with angles relative to defect displayed.