Nasolabial Transposition Flap for Reconstruction of Oncological Defects of the Cheek: Regarding a Case View PDF

^*Hember Suarez
Department Of General Surgery, Policlínico Del Docente, Buenos Aires, Argentina
Mariana Gallosa
Pediatric General Surgery Service, Policlínico Del Docente, Buenos Aires, Argentina
Jenniffer Santistevan
Pediatric General Surgery Service, Policlínico Del Docente, Buenos Aires, Argentina
Julieta Czarnitzki
Pediatric General Surgery Service, Policlínico Del Docente, Buenos Aires, Argentina
Martin Claudio
Pediatric General Surgery Service, Policlínico Del Docente, Buenos Aires, Argentina
Hugo Ruiz
Pediatric General Surgery Service, Policlínico Del Docente, Buenos Aires, Argentina

^*Corresponding Author:

Hember Suarez
Department Of General Surgery, Policlínico Del Docente, Buenos Aires, Argentina

Published on: 2026-04-10

Abstract

Skin flaps from the surrounding area, respecting the aesthetic units and subunits of the face, provide a tissue rich in vascularization; it is a challenge for the surgeon, requiring a deep understanding of the anatomy, danger zones, corresponding function of each muscle and the reconstructive techniques available to achieve functionally and aesthetically satisfactory results. A 56-year-old female presents with a history of schizophrenia, epilepsy and surgical resection of a left frontal meningioma. She presents with a pigmented, ulcerated lesion of approximately 3 × 3 cm in diameter on the right cheek that had been growing for the last several months. Patients underwent removal of the skin tumor with a 0.5 mm safety margin throughout its length, resulting in a defect affecting the medial region of the right infraorbital cheek. The surgical technique consisted of reconstructing that defect with a nasolabial transposition flap. Pathology reports ulcerated metatypical basal cell carcinoma (BCC) with free margins. Due to good postoperative progress, the patient is discharged. 25 days after surgery, we can demonstrate good aesthetic results.

Keywords

Facial skin defects, Basal cell carcinoma, Skin flaps, Safety margins

Introduction

Facial defects are frequently sequelae resulting from BCC, squamous cell carcinomas, melanomas, large benign tumors, or soft tissue trauma. The aesthetic units and subunits of the face, skin texture and color, along with other parameters, must be considered during the planning of reconstruction using local flaps [1].

There are different techniques for raising local flaps, including rotation, translation, advancement, and island flaps. Thus, we can see various flaps used in different regions, the most frequent being the forehead flap, advancement flap, cheek rotation flap, rhomboid flaps, cervicofacial flaps, bilobed flaps, and nasolabial flaps [2].

The cheek is the largest facial aesthetic region and is generally divided into four subunits: medial (infraorbital), lateral (masseteric or mandibular), zygomatic, and buccal. The boundaries of this region are defined by a line extending from the lateral canthus to the root of the helix, another line crossing the preauricular sulcus, another along the inferior margin of the mandible, and one passing through the mentolabial fold, the nasofacial groove, and the junction between the eyelid and cheek [3].

The difficulty in repairing these defects lies in the need to restore facial symmetry and three-dimensionality; therefore, they have a direct psychological and aesthetic impact. The presentation of this clinical case aims to show a patient with carcinoma in the medial region of the cheek, whose cutaneous defect can have a direct psychological and aesthetic impact, posing a surgical challenge.