Superficial temporal artery perforator flap for reconstruction of periorbital and eyelid defects, a variant of the classic flaps dissected in perforator flap

Introduction: The eyelids reconstruction presents an aesthetic, but above all, a functional challenge. It must allow the good protection of the cornea. The development of perforator flaps is major in recent years and is gradually spreading to the face, which has pushed us to apply it to palpebral surgery.

Material and method: Since 2014, in the maxillofacial surgery department of St Etienne, four patients have benefited from a palpebral reconstruction. A temporal perforator flap, dissected on a perforator of the superficial temporal artery was performed for the anterior lamella and a palatal mucosa graft for the tarsal reconstruction.

Results: The results were satisfying. Functionally, this technique allowed good occlusion of the eyelid and prevented the occurrence of ocular complications. On the aesthetic view, the position of the neo-eyelids is satisfying. No patient need retouching. The perforator flap allowed a significant mobilization without distortion of neighboring tissues, and maintaining frontal contractility.

Discussion: This contemporary approach to flap dissection provides a good functional result, reduces the sequelae of the donor site and does not impose a secondary aesthetic gesture. However, despite these advantages, this type of dissection has the disadvantage of being technically more delicate and requires a trained operator.