A New Technique for Closure of Infraorbital Defects

Abstract

The infraorbital region is a unique facial subunit surrounded with several important structures, such as the lower eyelids, oral commissure, ala nasi, and the sideburns. The potential for distortion of these neighboring anatomic landmarks and the absence of natural creases where incisional scars can be camouflaged make reconstruction of large infraorbital defects a challenge. A new local flap procedure for reconstruction of large infraorbital skin defects, named Mutaf triangular closure technique, is described. In this procedure, the defect is surgically converted to a triangle in shape. Then, the triangular defect is closed by transposition of 2 skin flaps designed in an unequal Z-plasty manner. Over 4 years, this technique has been used for closure of the infraorbital defects in 12 patients (7 men and 5 women), aged 28 to 83 years. The defect size ranged between 1.7 and 8 cm in diameter. A tension-free defect closure was obtained in all patients. All flaps healed with no complications. No patient had "dog-ear" formation, ectropion, scleral show, or distortion of the surrounding anatomic structures. A mean follow-up of 18 months (5 months-3.5 years) revealed an aesthetically acceptable scar formation in all patients. The Mutaf triangular closure technique seems to be a useful procedure for the closure of considerably large infraorbital defects with alike local tissue. It provides a tension-free closure without displacement and/or distortion of the neighboring mobile anatomic structures.