A Novel Flap for the Reconstruction of Midcheek Defects

Abstract

Cheek defects generally occur because of reasons such as trauma, burn, and tumor excisions. In the reconstruction of cheek defects, it is essential to cover the defects using the tissues with compatible color and similar texture. Although many techniques have been described for this purpose, local flaps are more likely to be used.In this study, we describe a new technique named "rabbit ear flap," which we used for the reconstruction of a 4.5 × 7-cm cheek defect due to basal cell carcinoma excision in a 71-year-old male patient. Two separate flaps on the extension of right facial artery with an inferior pedicle on the nasolabial region (hairless skin) and a superior pedicle flap that extended from right oral commissure to the submandibular region (hairy skin) were used. The hairy skin part of the defect was closed via the hairy skin flap, whereas the hairless region was closed with the hairless skin flap. The donor sites were closed primarily.No complication was encountered in the early or long-term follow-ups. In the 28-month follow-up of the patient, it was observed that the color and texture compatibility was fine, the natural beard integrity was obtained, the donor site scarring was minimal, and the scarring was camouflaged well in the anatomical lines.This technique is supposed to be an alternative method for reconstruction of medium-sized cheek defects because it is a simple, reliable, and single-session procedure, and because of its similar color and texture, it offers satisfactory aesthetic and functional outcomes due to natural beard restoration.

Approach to Reconstruction of Cheek Defects

“…The rabbit ear flap is indicated for intermediate-sized defects located at the junction between the zygomatic and buccal region. 10 The bipedicle flap includes an inferiorly based hairless skin flap that is elevated from the nasolabial region, and a superiorly based hairy skin flap that is elevated from the oral commissure to the submandibular region. The pivot point between the flaps is located at the oral commissure, and both flaps are rotated toward each other and closed primarily.…”