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The Single-Stage Facial Artery Perforator Flap for Nasal Reconstruction: Technique & Outcome in 8 Cases
Zachary A. Koenig, MD
Iraj Hasan, BS
Majed Maalouf, MD
West Virginia University School of Medicine
2024-01-15
Presenter: Zachary A. Koenig, MD
Affidavit:
January 15, 2024
To Whom It May Concern:
Zack Koenig, MD is a PGY-2 resident in plastic surgery at West Virginia University. I certify that the material in his abstract has not been published or presented at a major scientific meeting.
Thank you,
Kerri
Director Name: Kerri M. Woodberry
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
Introduction
Nasolabial flaps are classically random pattern flaps. Anatomic studies demonstrated multiple facial and lateral nasal artery perforators in nasolabial sulcus enabling a free-style propeller skin flap. Utilization of this flap bestows numerous advantages ranging from single-stage reconstruction to increased arc of rotation and breadth of coverage attained. However, its application in rural and underserved populations has not been reported.
Methods
A retrospective review of 6 patients who underwent nasal ala and inferolateral side wall reconstruction with nasolabial propeller flaps after Mohs surgery was conducted. Operations were performed by a single surgeon, and patients followed up for at least 8 weeks. Multiple variables were collected including demographics, comorbidities, and various aspects related to the reconstruction.
Results
8 nasolabial propeller flaps were performed. Mean distance traveled to Ruby Memorial Hospital was 90.5 ± 73.7 miles. Average number of hospital visits needed to attain coverage was 4 ± 0.5 including preoperative visits, Mohs surgery, and reconstructive surgery. Average surgery length was 45.1 ± 11.6 minutes. Average defect size was 2.5 ± 1.9 cm2. Debulking revision for improved cosmetics was performed in 25% (2/8) flaps, and no other complications were observed.
Conclusions
Nasolabial propeller flaps for nasal reconstruction are reproducible and provide benefits inherent to the surgery itself. The flaps' versatility provides reliable and acceptable aesthetic outcomes with high patient-satisfaction rates. Notably, it eases the burden on patients who would otherwise have to make even more trips to achieve coverage. It is a valuable addition to the plastic surgeon's armamentarium for nasal reconstruction.
