Vascular Basis of the Facial Artery Perforator Flap

Qassemyar, Q.; Havet, É.; Sinna, R.

doi:10.1097/prs.0b013e31822b6771

Cited by 87 publications

(74 citation statements)

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“…One such example is the modiolus perforator flap described by Gunnarsson and Thomsen [6] wherein they describe the use of a musculocutaneous perforator in a window of soft tissue bounded superiorly by the zygomaticus major, inferiorly by the risorius, medially by the oral commissure and laterally, by the facial artery. This consistent perforating vessel has been described by other studies [7] and is the source perforator used for the perforator-plus labio-mandibular flap. However, one of the issues with the use of propeller or islanded flaps is the later onset of lymphoedema; an unaesthetic feature.…”

Section: Discussionsupporting

confidence: 83%

The labio-mandibular flap for upper lip and peri-commissural defects

Kannan¹,

Nduka²

2018

PAR

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Aim: Peri-commisural defect reconstruction using the Abbe or Estlander flaps tend to pilfer tissue from the lower lip, contributing to microstomia, with its attendant problems. In this study, we aim to design a flap for more superficial defects, in which the underlying orbicularis oris muscle can be preserved when resecting peri-commisural skin malignancies whilst also ensuring completeness of excision. Methods:In a retrospective case review of 7 cases at our institution over a 12-month period (2016-2017), we conceptually designed a perforator-plus fascio-cutaneous flap from within the labio-mandibular fold with a 6-month follow-up in terms of oncological clearance and aesthetic outcome. The cohort was composed of patients with skin cancers e.g. basal and squamous cell carcinomas, presenting to a tertiary care facial plastic surgery centre. The technique involved raising a flap from within the peri-oral area, with a scar disguised along the labio-mandibular and naso-labial folds which allows for both an aesthetic reconstruction and the preservation of the oral sphincter mechanism, by avoiding microstomia. The outcomes measured were (1) to ascertain whether this procedure is oncologically safe, (2) there were instances of microstomia and (3) aesthetic appearance.Results: All oncological lesions were completely excised in all cases and at up to six months' follow-up, there were no instances of recurrence. Functionally, oral sphincter function was preserved in all instances as was aesthetic appearance. Conclusion:The labio-mandibular flap is an oncologically safe procedure for skin cancers whilst preserving oral sphincter function and maintaining aesthetics. It is hence, a superior alternative to Abbe and Estlander flaps, for more superficial defects, not requiring mucosal excision.

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Section: Discussionsupporting

confidence: 83%

The labio-mandibular flap for upper lip and peri-commissural defects

Kannan¹,

Nduka²

2018

PAR

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“…The length of the flap should be determined so that it can cover the most distant edge of the defect with appropriate transposition or rotation movement. As described by Qassemyar et al, 6 the facial artery perforators are located predominantly between 1 and 2 cm lateral to the level of the oral commissure, and therefore this specific area should be dissected carefully to preserve the appropriate perforator. This specific knowledge should be taken into consideration in flap planning so that this perforator-rich area has to be at the base of the flap.…”

Section: Surgical Techniquementioning

confidence: 99%

Facial Artery Perforator and Depressor Anguli Oris Muscle Chimeric Flap

Sarıcı

Yeşïloğlu

Temiz

et al. 2016

Annals of Plastic Surgery

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“…Pinar et al demonstrated that the external diameter of the facial artery was 2.6 mm (ranging from 1.7 to 3.6 mm) as it crossed the mandible. 16 The diameter of the artery measured in this study was 3.5 mm (Fig. 6).…”

Section: Discussionmentioning

confidence: 53%

“…12 Qassemyar et al reported that the facial artery perforators seem to be mainly located 15 mm lateral to the level of the oral commissure. 16 Squaquara et al reported that the facial artery passes upwards and forward to a point 13.8 mm (ranging from 10 to 16 mm) lateral to the commissure of the mouth. 8 Pinar et al demonstrated that the facial artery is located 15.5 mm (ranging from 9.0 to 20.2 mm) lateral to the angle of the mouth.…”

Section: Discussionmentioning

confidence: 99%

“…17 Koh et al reported that the distance between the stomion and the facial artery was 45.7 mm in male and 43.5 mm in female. 16 Regarding the measurements from previous literatures, the facial artery is located at 9 to 21 mm from the oral commissure and deep into the skin at 4 to 16 mm. Dermal filler injection should be avoided in the maximum risk of facial artery complication lateral to the oral commissure located at 15.3 mm (15-20 mm, risk 50.0%) at the depth from the skin of 11.1 mm (10-15 mm, risk 53.9%) (Fig.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The Soft Tissue Landmarks to Avoid Injury to the Facial Artery During Filler and Neurotoxin Injection at the Nasolabial Region

Phumyoo

Tansatit

Rachkeaw

2014

Journal of Craniofacial Surgery

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The aim of this study was to locate the course of the facial artery and to propose "the danger line" vulnerable to vascular complications following filler injection. The entire facial soft tissues were harvested from 14 Thai soft embalmed cadavers as a facial flap specimen. Measurements of the distance, the depth, and the diameter of the facial artery were done at level of the oral commissure and the nasal ala. The distance between the facial artery and the oral commissure was 15.3 ± 3.7 mm and the depth from the skin was 11.1 ± 3.1 mm. The distance between the facial artery and the nasal ala was 6.7 ± 4.4 mm and the depth was 11.6 ± 3.7 mm. The diameters of the facial artery at level of the oral commissure and the nasal ala were 2.6 ± 0.8 and 1.9 ± 0.5 mm, respectively. Maximum risk of arterial complication from dermal filler injection lateral to the oral commissure is located approximately 15 mm at the depth of 11 mm. High risk of arterial injury at the lateral nasal ala is located at 7 mm with the depth of 12 mm.

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Vascular Basis of the Facial Artery Perforator Flap

Cited by 87 publications

References 0 publications

The labio-mandibular flap for upper lip and peri-commissural defects

The labio-mandibular flap for upper lip and peri-commissural defects

Facial Artery Perforator and Depressor Anguli Oris Muscle Chimeric Flap

The Soft Tissue Landmarks to Avoid Injury to the Facial Artery During Filler and Neurotoxin Injection at the Nasolabial Region

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