ABSTRACT
This article attempts to put perforator flaps, as they apply to head and neck reconstruction,
into perspective. The importance of existing flaps is emphasized. Specific indications
for perforator flaps are highlighted. The deep inferior epigastric artery perforator
flap is used as the flap of choice for subtotal glossectomy defects by the authors.
The anterolateral thigh flap is the most common flap currently used. Indications for
its use are highlighted. Facial artery perforator flaps are introduced, and their
roles as local flaps in head and neck reconstruction are highlighted. With our better
understanding of vascular anatomy, existing flaps such as the submental flap have
been recategorized as perforator flaps. Its role in reconstruction, particularly of
lower facial defects, is discussed. Finally the internal mammary artery perforator
flap is described and its advantages over the deltopectoral flap and the pectoralis
major flap outlined.
KEYWORDS
Head and neck reconstruction - facial artery perforator flap - DIEAP flap - anterolateral
thigh flap - submental flap - internal mammary artery perforator flap
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Peter C NeliganM.B. F.R.C.S.(I) F.R.C.S.C. F.A.C.S.
200 Elizabeth Street 8N865, Toronto, Ontario, Canada M5G 2C4