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Related Experiment Video

Updated: Jan 14, 2026

Engineered Vascularized Muscle Flap
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Propeller Modification of Tapia's Flap.

Claudio Angrigiani, Jaume Masia, Andrés Peñaranda

    Aesthetic Surgery Journal
    |October 23, 2025
    PubMed
    Summary
    This summary is machine-generated.

    This study modifies the Tapia flap for malar enhancement in facelifts, using the transverse facial artery for reliable vascularization. The modified flap ensures permanent volume and high patient satisfaction, improving tear trough aesthetics.

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    Area of Science:

    • Plastic Surgery
    • Reconstructive Surgery
    • Anatomy

    Background:

    • The original Tapia flap, based on the superficial musculoaponeurotic system (SMAS), was used for malar enhancement in facelifts but had random vascularization.
    • This limited its reliability and potential for optimal placement.

    Purpose of the Study:

    • To describe a modified Tapia flap technique for malar volume enhancement in facelifts.
    • To evaluate the vascularization of this modified flap using the transverse facial artery.
    • To present clinical outcomes and patient satisfaction with this enhanced technique.

    Main Methods:

    • A modified Tapia flap was designed as an island, vascularized by the transverse facial artery perforator, and rotated into the pre-zygomatic space.
    • Anatomical dissection was performed on 14 cadavers to confirm the consistent presence and branching of the transverse facial artery.
    • A retrospective analysis of 42 patients who underwent the modified flap procedure as part of a facelift was conducted, with follow-up including clinical evaluation and ultrasonography.

    Main Results:

    • The anatomical study confirmed consistent vascular supply from the transverse facial artery to the SMAS.
    • Clinical follow-up of 42 patients showed complete flap survival, permanent malar volume without reabsorption, and high patient satisfaction.
    • The modified flap allowed for better in-setting and improved reach into the tear trough area.

    Conclusions:

    • This modification of the Tapia flap, utilizing the transverse facial artery, ensures reliable vascularization and long-term volume preservation for malar enhancement.
    • The technique offers improved aesthetic outcomes, particularly in the tear trough region, and high patient satisfaction.
    • This approach represents a significant advancement in facelift procedures for facial rejuvenation.