Bilateral interdigitated Pacman flap for round and oval facial defects

Area of Science:

• Plastic Surgery
• Dermatologic Surgery
• Reconstructive Surgery

Background:

• Facial defect reconstruction requires attention to skin texture, color, and anatomical borders.
• Local flaps are preferred for preserving facial aesthetics.
• Previous methods included bilateral interdigitated VY flaps for facial defect repair.

Observation:

• A modified bilateral Pacman flap technique was used for round and oval facial defects.
• The study reviewed 25 patients (26 cases) undergoing this repair after Mohs surgery.
• Defect sizes varied from 0.7 to 8.4 cm² (mean 3.1 cm²).

Findings:

• Successful defect coverage and flap survival were achieved in all cases.
• One patient experienced minor, self-resolving partial flap necrosis.
• No significant flap contraction, distortion, or severe scarring occurred during 12-month follow-up.

Implications:

• The bilateral interdigitated Pacman flap is effective for round and oval facial defects.
• This technique avoids central dog-ear deformity and distortion.
• It presents a valuable option for facial restoration in specific reconstructive scenarios.