Crescentic Back Cut: A Novel Technique for the Management of Flap/Defect Discrepancies in Rotation Flaps

Facial reconstruction requires the use of various techniques to repair cutaneous defects. Sliding flaps, such as advancement and rotation flaps, typically result in tension alterations and skin redundancy, necessitating a secondary defect.

We describe a back cut technique that allows minimization of the scar line and appropriate placement of tension vectors in certain locations, which we call the crescentic back cut.

A patient with a surgical defect on his preauricular cheek is repaired by use of a rotation flap modified with a crescentic back cut. We briefly review the alternative methods for management of flap/defect discrepancies in rotation flaps.

The crescentic back cut is simple to suture, can be adjusted in length and thickness to minimize pedicle transection, and keeps the scar short and within the relaxed skin tension lines.

The crescentic back cut is a useful option to manage flap/defect discrepancies in rotation flaps.