title: Reconstruction of skin defects in the medial cheek using lateral cheek rotation flap combined with Z-plasties.
abstract: BACKGROUND
  Cervicofacial flaps are commonly used in the reconstruction of skin defects in regions such as the medial cheek and lower eyelid. However, their drawbacks include long flap incision, extensive undermining, and a high possibility of postoperative complications including distal flap necrosis and lower eyelid ectropion.
  
  
  METHODS
  Nine cases of reconstruction of skin defects in the medial cheek and adjacent areas were performed using a lateral cheek rotation flap in combination with Z-plasties between October 2009 and August 2014. In the surgery, the defect was trimmed into a downward-pointing triangle, with the flap incision line starting from the bottom edge of the defect and extending outward in the lateral orbital direction in an arc until before the sideburn. After the flap was undermined, double or quadruple Z-plasties were performed along the lateral orbital incision line to elongate the flap.
  
  
  RESULTS
  All flaps survived without the occurrence of complications such as hematoma, wound infection, distal flap necrosis, and lower eyelid ectropion. During the follow-up period, the flaps exhibited good color and texture. A natural looking cheek was restored without obvious scars.
  
  
  CONCLUSIONS
  A lateral cheek rotation flap in combination with Z-plasty is an optimal method for reconstruction of skin defects in the medial cheek and lower eyelid region. Compared to conventional cervicofacial flaps, the lateral cheek rotation flap was shown to have a variety of advantages, including a simpler operation, shorter flap incision, minimal undermining, and effective prevention of complications such as lower eyelid ectropion and distal flap necrosis.
authors.affiliation: Department of Plastic and Cosmetic Surgery, Dongguan People's Hospital, No.3 Wandao Road, Wanjiang District, Dongguan 523018, China. Electronic address: Dgzxmrlxr@aliyun.com.
authors.forename: Xiaorong
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Plastic and Cosmetic Surgery, Dongguan People's Hospital, No.3 Wandao Road, Wanjiang District, Dongguan 523018, China.
authors.forename: Yusheng
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Plastic and Cosmetic Surgery, Dongguan People's Hospital, No.3 Wandao Road, Wanjiang District, Dongguan 523018, China.
authors.forename: Keqiong
authors.initials: K
authors.lastname: Chen
authors.affiliation: Department of Plastic and Cosmetic Surgery, Dongguan People's Hospital, No.3 Wandao Road, Wanjiang District, Dongguan 523018, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Department of Plastic and Cosmetic Surgery, Dongguan People's Hospital, No.3 Wandao Road, Wanjiang District, Dongguan 523018, China.
authors.forename: Weilong
authors.initials: W
authors.lastname: Huang
authors.affiliation: Department of Plastic and Cosmetic Surgery, Dongguan People's Hospital, No.3 Wandao Road, Wanjiang District, Dongguan 523018, China.
authors.forename: Wenwei
authors.initials: W
authors.lastname: Yuan
authors.affiliation: Department of Otolaryngology-Head and Neck, Sun Yat-sen Hospital, Sun Yat-sen University, 107, Yan Jiang West Road, Guangzhou 510120, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Cai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002610:Cheek / Q000601:surgery*; D005143:Eyelids / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012871:Skin Diseases / Q000601:surgery*; D013524:Surgical Flaps; D016896:Treatment Outcome
keywords: Cheek; Rotation flap; Skin defect; Z-plasty