Medial advancement of the cheek: a simple method of infraorbital cheek reconstruction

The flaps commonly used for small or medium-sized reconstruction of the infraorbital region of the cheek have some drawbacks, mainly visible scars and/or pincushioning of the flap itself. A simple method to reconstruct infraorbital cheek defects, with less noticeable scars while respecting the aesthetic sub-unit is described and discussed. It consists of a triangular flap from the cheek lateral to the defect, which is advanced medially. Most surgeons know the basis of this technique. From January 1997 to January 2001, 29 patients were operated on using this method after tumor resection. Apart from some postoperative eyelid edema and bruising which resolved spontaneously, the aesthetic result was considered satisfactory by all patients. In fact, the scars were barely noticeable after only a few weeks becoming hidden in expression lines or natural creases because the incisions are performed in, or parallel to, natural creases, relaxed tension skin lines or expression lines. Defects of the infraorbital region of the cheek without eyelid involvent, up to a vertical line passing through the lateral canthus, can be closed by this method. In conclusion, the above technique is easy, effective and reliable, and the scars are inconspicuous.