The labia minora or nymphae of the vulva are two cutaneous-mucosal refolds located between the labia majora, the internal aspect of which is separated by the interlabial cleft. The enlargement of the labia minora may be attributable to several factors, most commonly congenital. Although some women require surgical reduction for functional reasons, most seek reduction of their labia minora because of psychological concerns. The authors describe a modified plastic surgery procedure for functional and aesthetic reduction of the labia minora.
Thirty superficial perineal neurovascular pedicles from 15 formaldehyde-fixed female cadavers were dissected and analyzed with the purpose of establishing the anatomic basis for the design and elevation of vulvoperineal fasciocutaneous flaps based on their anatomic elements. The average internal diameter of the superficial perineal artery was 0.53 +/- 0.2 mm, determined by means of an image analysis system. Three distinct anatomic patterns of cutaneous arterial vascularization were seen bilaterally, and two types of vulvoperineal fasciocutaneous flaps are described.
Presented here are two clinical cases of extensive defects of the scalp secondary to surgical resection of invasive basal cell carcinoma on the parietal region, successfully treated by means of very large, bipedicled fronto-occipital flaps, based anteriorly on the supratrochlear-supraorbital vessels and posteriorly on the occipital and posterior auricular vessels. Considering both the location and the large size of the scalp defects, different surgical techniques are discussed and the potential use of bipedicled scalp flaps is considered, designed either sagittally or coronally as fronto-occipital or temporo-temporal flaps. The bipedicled fronto-occipital scalp flap is believed to represent a simple, secure, and useful reconstructive procedure for cutaneous coverage of extensive defects located on the lateral scalp.
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