Bilobed Flap Reconstruction in Infraorbital Skin Defects

Abstract

The infraorbital region is an important subunit for facial aesthetics. Improper closure of skin defects involving this region may lead to deformity in the lower lid and to ectropion. This report presents the authors' experience with 15 patients who had infraorbital skin defects reconstructed with the bilobed flap from the zygomatic and lateral cheek regions. Most of the operations were performed under local anesthesia. Pathologic diagnoses included basal cell carcinoma, squamous cell carcinoma, melanoma, and hemangioma. Although we cannot deny that bilobed flaps used in this series were not random flaps, we would like to emphasize that when a flap with a bilobed design is chosen for reconstruction of an infraorbital defect, a superiorly based bilobed flap should be selected to avoid ectropion or any distortion in the middle face. As an adjunct procedure, a glabellar flap was used in some patients who had defects extending medially as well. The results of the repair were satisfactory with respect to color match, texture, and functional properties. The superiorly based bilobed flap should be always kept in mind when planning a local flap in the infraorbital region.