Progress of anatomic research and clinical application of facial artery perforator flap_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WANGDi ,  CHENWen

Plastic Surgery Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100041, P.R.China;

Corresponding author：

CHENWen, Email: chenwencw@163.com

Keywords：

Facial artery perforator flap; anatomical research; face repair

DOI：

10.7507/1002-1892.201608129

Video：

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Objective To summarize the present status and progress of the anatomy researches and clinical application of the facial artery perforator flap (FAPF). Methods The relative researches focused on the anatomy researches and clinical application of FAPF were extensively reviewed, analyzed, and summarized. Results The facial artery perforator (FAP) has constant anatomy. There are more facial artery perforators in the perioral region, and each FAP has two accompanying veins. Distinguished by inferior mandibular border, the upper and the lower flaps both are used for reconstruction of defects on the face. The most widely-used upper flap was FAPF, which is excellent choice of defects in mid-face. Additionally, angular artery perforator flap and lateral nasal artery perforator flap are becoming more and more popular. While submental artery perforator flap, whose pedicle locates under inferior mandibular border, is most used for reconstruction of lower face. FAPF for face defect repair can achieve good outcomes of function and appearance in clinical application. Conclusion Based on multiple advantages of good aesthetics and function outcomes, high survival rate, flexible design, and simple operation, FAPF is an optimal choice for defect repair of perioral region and nasal ala. However, Further study is needed to determine whether retaining tissue around the pedicle will affect vein reflux of the flap.

Citation： WANGDi, CHENWen. Progress of anatomic research and clinical application of facial artery perforator flap. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(2): 246-250. doi: 10.7507/1002-1892.201608129 Copy

1.	Hofer SO, Posch NA, Smit X. The facial artery perforator flap for reconstruction of perioral defects. Plast Reconstr Surg, 2005, 115(4): 996-1005.
2.	Camuzard O, Foissac R, Georgiou C, et al. Facial artery perforator flap for reconstruction of perinasal defects: An anatomical study and clinical application. J Craniomaxillofac Surg, 2015, 43(10): 2057-2065.
3.	Ng ZY, Fogg QA, Shoaib T. Where to find facial artery perforators: A reference point. J Plast Reconstr Aesthet Surg, 2010, 63(12): 2046-2051.
4.	Qassemyar Q, Havet E, Sinna R. Vascular basis of the facial artery perforator flap: analysis of 101 perforator territories. Plast Reconstr Surg, 2012, 129(2): 421-429.
5.	Houseman ND, Taylor GI, Pan WR. The angiosomes of the head and neck: anatomic study and clinical applications. Plast Reconstr Surg, 2000, 105(7): 2287-2313.
6.	Saint-Cyr M, Wong C, Schaverien M, et al. The perforasome theory: vascular anatomy and clinical implications. Plast Reconstr Surg, 2009, 124(5): 1529-1544.
7.	Hwang K, Han JY, Chung RS, et al. Submental perforating artery: a culprit of bleeding during facelift. Journal of Craniofacial Surgery, 2005, 16(1): 3-5.
8.	Tang ML, Ding MH, Almutairi K, et al. Three-dimensional angiography of the submental artery perforator flap. J Plast Reconstr Aesthet Surg, 2011, 64(5): 608-613.
9.	马大梦, 李小静, 宁金龙, 等. 内眦动脉为蒂的角形穿支皮瓣的解剖基础与临床应用. 中华整形外科杂志, 2015, 31(4): 241-245.
10.	Lombardo GA, Tamburino S, Tracia L, et al. Lateral nasal artery perforator flaps: anatomic study and clinical applications. Arch Plast Surg, 2016, 43(1): 77-83.
11.	Kannan RY, Mathur BS. Perforator flaps of the facial artery angiosome. J Plast Reconstr Aesthet Surg, 2013, 66(4): 483-488.
12.	Kannan RY. Supraplatysmal submental artery perforator flap: minimizing risk to the marginal mandibular nerve. Ann Plast Surg, 2014, 72(1): 131.
13.	Mutlu ÖÖ, Yasak T, Egemen O, et al. The use of submental artery perforator island flap without including digastric muscle in the reconstruction of lower face and intraoral defects. J Craniofac Surg, 2016, 27(4): e406-e409.
14.	Potter S, De Blacam C, Kosutic D. True submental artery perforator flap for total soft-tissue chin reconstruction. Microsurgery, 2012, 32(6): 502-504.
15.	Shi CL, Wang XC. Reconstruction of lower face defect or deformity with submental artery perforator flaps. Ann Plast Surg, 2012, 69(1): 41-44.
16.	王先成, 李晓芳, 鲁青, 等. 颏下动脉穿支皮瓣修复面下部畸形及缺损. 中华整形外科杂志, 2010, 26(1): 18-20.
17.	Chen W, Li Y, Wang N. The need for a complete platysma component for platysma myocutaneous flaps?——an introduction of the expanded cutaneous-dominant platysma flap for facial defect reconstruction. J Plast Reconstr Aesthet Surg, 2010, 63(12): 2172-2176.
18.	Krijgh DD, Mureau MA. Aesthetic and functional outcome following perioral defect reconstruction using the facial artery perforator flap. J Reconstr Microsurg, 2012, 28(8): 529-538.
19.	Du YF, Zhou WN, Li J, et al. A new design of facial artery perforator flaps for the reconstruction of small- to medium-sized intraoral defects. J Craniofac Surg, 2014, 25(6): 2098-2100.
20.	Durgun M, Ozakpinar HR, Sari E, et al. The versatile facial artery perforator-based nasolabial flap in midface reconstruction. J Craniofac Surg, 2015, 26(4): 1283-1286.
21.	Sarici M, Yesiloğlu N, Temiz G, et al. Facial artery perforator and depressor anguli oris muscle chimeric flap: A new design of an old flap. Ann Plast Surg, 2015, 77(2): 178-182.
22.	Yoon TH, Yun IS, Rha DK, et al. Reconstruction of various perinasal defects using facial artery perforator-based nasolabial island flaps. Arch Plast Surg, 2013, 40(6): 754-760.
23.	张培培, 杨超, 邢新, 等. 面动脉穿支皮瓣修复鼻、唇与颊部皮肤软组织缺损.中华整形外科杂志, 2016, 32(1): 35-38.
24.	Ruiz-Moya A, Lagares-Borrego A, Infante-Cossio P. Propeller facial artery perforator flap as first reconstructive option for nasolabial and perinasal complex defects. J Plast Reconstr Aesthet Surg, 2015, 68(4): 457-463.
25.	Duzgun S, Unlu E, Bali Y. A new facial artery free-style perforator flap and conchal cartilage graft for one-step reconstruction of the alar defects. J Craniofac Surg, 2013, 24(6): 2053-2055.
26.	D’Arpa S, Pirrello R, Toia F, et al. Reconstruction of nasal alar defects with freestyle facial artery perforator flaps. Facial Plastic Surg, 2014, 30(3): 277-286.
27.	Karsidag S, Ozcan A, Sumer O, et al. Single-stage ala nasi reconstruction: lateral nasal artery perforator flap. J Craniofac Surg, 2010, 21(6): 1887-1889.
28.	Coronel-Banda ME, Serra-Mestre JM, Serra-Renom JM, et al. Reconstruction of nasal septal perforations in cocaine-addicted patients with facial artery mucosa-based perforator flap. Plast Reconstr Surg, 2014, 133(1): 82e-83e.
29.	Kim SW, Kim YH, Kim JT. Angular artery perforator-based transposition flap for the reconstruction of midface defect. Int J Dermatol, 2012, 51(11): 1366-1370.
30.	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(12): 1616-1620.
31.	D’Arpa S, Cordova A, Pirrello R, et al. Free style facial artery perforator flap for one stage reconstruction of the nasal ala. J Plast Reconstr Aesthet Surg, 2009, 62(1): 36-42.
32.	吴晓勇, 熊猛. 面动脉及其分支的解剖研究及临床价值. 中国美容医学, 2013, 22(5): 523-525.

1. Hofer SO, Posch NA, Smit X. The facial artery perforator flap for reconstruction of perioral defects. Plast Reconstr Surg, 2005, 115(4): 996-1005.
2. Camuzard O, Foissac R, Georgiou C, et al. Facial artery perforator flap for reconstruction of perinasal defects: An anatomical study and clinical application. J Craniomaxillofac Surg, 2015, 43(10): 2057-2065.
3. Ng ZY, Fogg QA, Shoaib T. Where to find facial artery perforators: A reference point. J Plast Reconstr Aesthet Surg, 2010, 63(12): 2046-2051.
4. Qassemyar Q, Havet E, Sinna R. Vascular basis of the facial artery perforator flap: analysis of 101 perforator territories. Plast Reconstr Surg, 2012, 129(2): 421-429.
5. Houseman ND, Taylor GI, Pan WR. The angiosomes of the head and neck: anatomic study and clinical applications. Plast Reconstr Surg, 2000, 105(7): 2287-2313.
6. Saint-Cyr M, Wong C, Schaverien M, et al. The perforasome theory: vascular anatomy and clinical implications. Plast Reconstr Surg, 2009, 124(5): 1529-1544.
7. Hwang K, Han JY, Chung RS, et al. Submental perforating artery: a culprit of bleeding during facelift. Journal of Craniofacial Surgery, 2005, 16(1): 3-5.
8. Tang ML, Ding MH, Almutairi K, et al. Three-dimensional angiography of the submental artery perforator flap. J Plast Reconstr Aesthet Surg, 2011, 64(5): 608-613.
9. 马大梦, 李小静, 宁金龙, 等. 内眦动脉为蒂的角形穿支皮瓣的解剖基础与临床应用. 中华整形外科杂志, 2015, 31(4): 241-245.
10. Lombardo GA, Tamburino S, Tracia L, et al. Lateral nasal artery perforator flaps: anatomic study and clinical applications. Arch Plast Surg, 2016, 43(1): 77-83.
11. Kannan RY, Mathur BS. Perforator flaps of the facial artery angiosome. J Plast Reconstr Aesthet Surg, 2013, 66(4): 483-488.
12. Kannan RY. Supraplatysmal submental artery perforator flap: minimizing risk to the marginal mandibular nerve. Ann Plast Surg, 2014, 72(1): 131.
13. Mutlu ÖÖ, Yasak T, Egemen O, et al. The use of submental artery perforator island flap without including digastric muscle in the reconstruction of lower face and intraoral defects. J Craniofac Surg, 2016, 27(4): e406-e409.
14. Potter S, De Blacam C, Kosutic D. True submental artery perforator flap for total soft-tissue chin reconstruction. Microsurgery, 2012, 32(6): 502-504.
15. Shi CL, Wang XC. Reconstruction of lower face defect or deformity with submental artery perforator flaps. Ann Plast Surg, 2012, 69(1): 41-44.
16. 王先成, 李晓芳, 鲁青, 等. 颏下动脉穿支皮瓣修复面下部畸形及缺损. 中华整形外科杂志, 2010, 26(1): 18-20.
17. Chen W, Li Y, Wang N. The need for a complete platysma component for platysma myocutaneous flaps?——an introduction of the expanded cutaneous-dominant platysma flap for facial defect reconstruction. J Plast Reconstr Aesthet Surg, 2010, 63(12): 2172-2176.
18. Krijgh DD, Mureau MA. Aesthetic and functional outcome following perioral defect reconstruction using the facial artery perforator flap. J Reconstr Microsurg, 2012, 28(8): 529-538.
19. Du YF, Zhou WN, Li J, et al. A new design of facial artery perforator flaps for the reconstruction of small- to medium-sized intraoral defects. J Craniofac Surg, 2014, 25(6): 2098-2100.
20. Durgun M, Ozakpinar HR, Sari E, et al. The versatile facial artery perforator-based nasolabial flap in midface reconstruction. J Craniofac Surg, 2015, 26(4): 1283-1286.
21. Sarici M, Yesiloğlu N, Temiz G, et al. Facial artery perforator and depressor anguli oris muscle chimeric flap: A new design of an old flap. Ann Plast Surg, 2015, 77(2): 178-182.
22. Yoon TH, Yun IS, Rha DK, et al. Reconstruction of various perinasal defects using facial artery perforator-based nasolabial island flaps. Arch Plast Surg, 2013, 40(6): 754-760.
23. 张培培, 杨超, 邢新, 等. 面动脉穿支皮瓣修复鼻、唇与颊部皮肤软组织缺损.中华整形外科杂志, 2016, 32(1): 35-38.
24. Ruiz-Moya A, Lagares-Borrego A, Infante-Cossio P. Propeller facial artery perforator flap as first reconstructive option for nasolabial and perinasal complex defects. J Plast Reconstr Aesthet Surg, 2015, 68(4): 457-463.
25. Duzgun S, Unlu E, Bali Y. A new facial artery free-style perforator flap and conchal cartilage graft for one-step reconstruction of the alar defects. J Craniofac Surg, 2013, 24(6): 2053-2055.
26. D’Arpa S, Pirrello R, Toia F, et al. Reconstruction of nasal alar defects with freestyle facial artery perforator flaps. Facial Plastic Surg, 2014, 30(3): 277-286.
27. Karsidag S, Ozcan A, Sumer O, et al. Single-stage ala nasi reconstruction: lateral nasal artery perforator flap. J Craniofac Surg, 2010, 21(6): 1887-1889.
28. Coronel-Banda ME, Serra-Mestre JM, Serra-Renom JM, et al. Reconstruction of nasal septal perforations in cocaine-addicted patients with facial artery mucosa-based perforator flap. Plast Reconstr Surg, 2014, 133(1): 82e-83e.
29. Kim SW, Kim YH, Kim JT. Angular artery perforator-based transposition flap for the reconstruction of midface defect. Int J Dermatol, 2012, 51(11): 1366-1370.
30. 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(12): 1616-1620.
31. D’Arpa S, Cordova A, Pirrello R, et al. Free style facial artery perforator flap for one stage reconstruction of the nasal ala. J Plast Reconstr Aesthet Surg, 2009, 62(1): 36-42.
32. 吴晓勇, 熊猛. 面动脉及其分支的解剖研究及临床价值. 中国美容医学, 2013, 22(5): 523-525.

Chinese Journal of Reparative and Reconstructive Surgery

Progress of anatomic research and clinical application of facial artery perforator flap

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