Nasolabial propeller perforator flap: Anatomical study and case series

Area of Science:

• Anatomy
• Plastic Surgery
• Vascular Surgery

Background:

• Facial artery perforator anatomy exhibits significant variability.
• Previous studies lack validation in the Colombian population.
• Understanding lateral nasal artery perforators is crucial for reconstructive surgery.

Purpose of the Study:

• To describe the vascular anatomy of lateral nasal artery cutaneous branches in Colombian cadavers.
• To evaluate the clinical applications of these perforators in nasal alar reconstruction.
• To address the variability reported in previous facial artery perforator studies.

Main Methods:

• Dissection of facial artery terminal branches and lateral nasal artery perforators in nine hemifaces from six fresh cadavers.
• Assessment of perforator quality, number, and distribution.
• Presentation of seven clinical cases of nasal alar reconstruction using these flaps.

Main Results:

• Cutaneous perforators were consistently identified in all hemifaces, predominantly in zone 2.
• All nasolabial propeller perforator flaps used for nasal alar reconstruction were successful.
• Minor venous congestion occurred in two cases, resolving without further intervention.

Conclusions:

• The nasolabial propeller perforator flap is a viable and effective option for nasal alar reconstruction.
• This flap offers precise skin island design, reduced bulk, and a wide arc of rotation.
• One-stage reconstruction is achievable with a low complication rate.