Reconstruction of cheek skin defects by the ‘Yin-Yang’ rotation of the Mustardé flap and the temporoparietal scalp

• Published in: Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2009-04, Vol.62 (4), p.506-509
• Main Authors: Belmahi, A, Oufkir, A, Bron, T, Ouezzani, S
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological and medical sciences; Carcinoma, Basal Cell - surgery; Cheek - surgery; Cheek defect; Esthetics; Facial Neoplasms - surgery; Female; Follow-Up Studies; Humans; Medical sciences; Middle Aged; Mustardé flap; Plastic Surgery; Reconstructive Surgical Procedures - methods; Rotation flap; Scalp - surgery; Skin Neoplasms - surgery; Skin plastic surgery; Suborbital region; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgical Flaps; Temporoparietal scalp; Treatment Outcome
• ISSN: 1748-6815; 1878-0539
• DOI: 10.1016/j.bjps.2007.11.012

Summary Background and purposes When the skin's laxity is limited, the preauricular cutaneous defect resulting from the Mustardé cheek rotation flap for the coverage of suborbital skin defects is very difficult to close even with a large undermining of the cervicofacial skin. The rotation of the temporoparietal scalp in an opposite direction compared to the Mustardé flap or the ‘Yin-Yang’ rotation of these flaps is interesting for two reasons: it allows an easy closure of this preauricular defect with a limited facial undermining and it suspends with efficiency the Mustardé flap at the temporal area avoiding the lower lid's ectropion. Material and methods From September 2001 to April 2005, nine patients aged between 35 and 78 years old, with no facial skin laxity, have benefited from this technique to cover suborbital defects secondary to excision of basal cell carcinomas with a mean diameter of 6 cm. The design of the Mustardé flap was classical but the skin undermining stopped at the mandible's lower border. The triangular preauricular defect has served as a geometrical base to design an opposite temporoparietal rotation flap which is undermined under the galea. Results This technique has allowed an easy primary closure of all these defects. No complications were reported. With a mean follow up of 36 months the aesthetic quality of these reconstructions was satisfying and there was no malposition of the lower lid. Conclusion This is a good technique for the simple coverage of medium-sized suborbital skin defects.