title: Propeller facial artery perforator flap as first reconstructive option for nasolabial and perinasal complex defects.
abstract: Facial cutaneous oncological pathology often involves more than one esthetic unit due to their close boundaries. The reconstruction of both the nasolabial and perinasal regions may be especially complex and challenging for the surgeon. Traditionally, these defects have been reconstructed with local random flaps based on the vascularization provided by the superficial musculoaponeurotic system. In this article, we present our experience in the reconstruction of the aforementioned defects using the propeller facial artery perforator (FAP) flap.
  
  
  METHODS
  A propeller FAP flap was performed for reconstruction in 12 patients with nasolabial or perinasal complex defects after tumoral resection between the years 2011 and 2013. The flap was designed parallel to the nasolabial fold in all cases for achieving direct closure and an aesthetically pleasing outcome. In one of the cases, a paramedian forehead flap was performed simultaneously.
  
  
  RESULTS
  Nine patients healed uneventfully, with good functional and esthetic outcomes. One of the flaps developed partial necrosis of the distal end, and another developed temporary postoperative venous congestion, lymphedema, and, finally, trapdoor deformity. The latter complication also occurred in one more flap.
  
  
  CONCLUSIONS
  The propeller FAP flap is reliable and versatile, with few complications, and it is especially useful when reconstructing complex defects that involve the nasolabial and perinasal regions; therefore, it should be considered as one of the first reconstructive options for the described defects.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Virgen del Rocío University Hospital, Seville, Spain. Electronic address: dr.ruizmoya@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Ruiz-Moya
authors.affiliation: Department of Plastic and Reconstructive Surgery, Virgen del Rocío University Hospital, Seville, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Lagares-Borrego
authors.affiliation: Department of Maxillofacial and Oral Surgery, Virgen del Rocío University Hospital, Seville, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Infante-Cossío
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000637:transplantation; D005145:Face / Q000473:pathology / Q000601:surgery*; D005153:Facial Neoplasms / Q000601:surgery; D005260:Female; D058752:Free Tissue Flaps; D006801:Humans; D008046:Lip; D008297:Male; D008875:Middle Aged; D009666:Nose; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000379:methods*
keywords: FAP; Facial artery; Facial reconstruction; Perforator flap; Propeller flap