Facial artery perforator flap for reconstruction of perinasal defects: An anatomical study and clinical application

Background: The concept of the facial artery perforator flap was developed for improved freedom during the reconstruction of perioral and perinasal defects. This flap enables tailor-made reconstruction and a shift from the traditional two-stage procedure to a one-stage technique. In this cadaveric study, the authors quantify the number, length, and diameter of facial artery perforators (FAPs) and present their clinical experience with the FAP flap.

Methods: The authors performed 20 dissections of facial arteries (FAs). All FAPs greater than 0.5 mm were dissected to study the number, length, and diameter of FAPs. In addition, the authors report a case series of 15 perinasal defect reconstruction procedures performed using facial artery-based perforator flap.

Results: A total of 125 FAPs were dissected. We identified a mean of six FAPs per hemiface (range five to eight). The average length of all FAPs was 17.6 ± 1.9 mm, and the mean diameter of the FAPs was 0.91 ± 0.2. Fifteen patients underwent a perinasal defect reconstruction using a FAP flap with good aesthetic and functional results.

Conclusions: The following study thus improves our understanding of FAP anatomy and clinical application and will enable the nasolabial fold to become the area where perinasal defect reconstruction using perforator flaps is performed.