Objective: Defects of the nasal, perinasal, and infraorbital areas usually develop after trauma or tumoral excision. The key points of reconstruction of these areas are achieving a good color match and tissue compatibility, avoiding or minimizing functional deficits, and preventing disfigurement in the surrounding tissue. This study is a review of midfacial defects reconstructed with a facial artery perforator flap.Methods: Nineteen patients were operated on for midfacial tumoral masses between 20082017. After excision of the lesion with the appropriate surgical margins, the resulting defects were reconstructed with facial artery perforator flaps. Recovering the anatomical and functional structure of the area or avoiding deterioration was the goal. In order to avoid ectropion, flaps were anchored to the periosteum when the lower eyelid was involved. All flap donor sites were primarily repaired. Results: In 1 patient, venous insufficiency was observed, and in another, hematoma and ecchymosis developed, but flap failure did not occur. A trap door deformity was observed in 2 flaps. The patients were satisfied with the aesthetic and functional outcomes.Conclusion: The facial artery perforator flap is a good option for reconstruction of midface defects because it is elevated in a single stage, it provides freedom to design and transfer, and the donor site can be primarily closed
1. D’Arpa S, Cordova A, Pirrello R, Moschella F. Free style facial artery perforator flap for one stage reconstruction of the nasal ala. J Plast Reconstr Aesthet Surg 2009;62:36–42.
2. Pepper JP, Baker SR. Local flaps: cheek and lip reconstruction. JAMA Facial Plast Surg 2013;15:374–82.
3. Salgarelli AC, Bellini P, Multinu A, Magnoni C, Francomano M, Fantini F, et al. Reconstruction of nasal skin cancer defects with local flaps. J Skin Cancer 2011;2011:181093.
4. Kim SW, Kim YH, Kim JT. Angular artery perforator-based transposition flap for the reconstruc-tion of midface defect. Int J Dermatol 2012;51:1366–70.
5. Brunetti B, Tenna S, Aveta A, Segreto F, Persichetti P. Angular artery perforator flap for recon-struction of nasal sidewall and medial canthal defects. Plast Reconstr Surg 2012;130:627e-8e.
6. Meara DJ. Acquired defects of the nose and naso-orbitoethmoid (NOE) region. Oral Maxillofac Surg Clin North Am 2013;25:131–49.
7. Sohn WI, Choi JY, Seo BF, Jung SN. Reconstruction of nasal ala with nasolabial perforator flap after cancer removal. Head Neck Oncol 2012;4:83.
8. Schubert J. Local flaps for the closure of facial defects. HNO 2013;61:433–46.
9. Wheatley MJ, Smith JK, Cohen IA. A new flap for nasal tip reconstruction. Plast Reconstr Surg 1997;99:220–4.
10. El-Marakby HH. The versatile naso-labial flaps in facial reconstruction. J Egypt Natl Canc Inst 2005;17:245–50.
11. Ersoy B, Aköz T. Tümör rezeksiyonu sonrası oluşan orta yüz defektlerinin onarımında nazola-bial V-Y ilerletme flebinin kullanımı. Maltepe Tıp Dergisi 2016;8:1–4.
12. Taylor GI, Palmer JH. The vascular territories (angiosomes) of the body: experimental study and clinical applications. Br J Plast Surg 1987;40:113–41.
13. Kroll SS, Rosenfield L. Perforator-based flaps for low posterior midline defects. Plast Reconstr Surg 1988;81:561–6.
14. Hofer SO, Posch NA, Smit X. The facial artery perforator flap for reconstruction of perioral de-fects. Plast Reconstr Surg 2005;115:996– 1003.
15. Ng ZY, Fogg QA, Shoaib T. Where to find facial artery perforators: a reference point. J Plast Reconstr Aesthet Surg 2010;63:2046–51.
16. Qassemyar Q, Havet E, Sinna R. Vascular basis of the facial artery perforator flap: analysis of 101 perforator territories. Plast Reconstr Surg 2012;129:421–9.
17. Kannan RY, Mathur BS. Perforator flaps of the facial artery angiosome. J Plast Reconstr Aes-thet Surg 2013;66:483–8.
18. Demirseren ME, Afandiyev K, Ceran C. Reconstruction of the perioral and perinasal defects with facial artery perforator flaps. J Plast Reconstr Aesthet Surg 2009;62:1616–20.