Repair of Apical Triangle Defects Using Melolabial Rotation Flaps

BACKGROUND The apical triangle of the upper cutaneous lip, also known as the alar-facial sulcus, is an anatomical structure bound medially by the nasal ala, laterally by the medial cheek, and inferiorly by the remainder of the upper cutaneous lip. During reconstruction, retaining the central concavity and the convex lateral and medial outlines of this location is required to maintain midfacial symmetry. OBJECTIVE This is a retrospective study of our use of the melolabial rotation flap for reconstruction of surgical defects of the apical triangle. METHODS AND MATERIALS Eighty-six surgical defects involving the apical triangle that were repaired with melolabial rotation flaps were included. All tumors were treated with Mohs micrographic surgery before reconstruction. Preoperative, intraoperative, and postoperative details of each case were analyzed. RESULTS Of the 86 defects included in the study, 68 (79%) were evaluated postoperatively. The apical triangle was preserved in all cases. Clinical asymmetry was noted in 3 patients (3.4%). No major complications were noted, and no patient required surgical revision. CONCLUSION Melolabial rotation flaps may be considered for single-stage reconstruction of surgical defects involving the apical triangle. Address correspondence and reprint requests to: Arash Kimyai-Asadi, MD, 7515 Main Street, Suite 240, Houston, TX 77030, or e-mail: akimyai@yahoo.com The authors have indicated no significant interest with commercial supporters. © 2018 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

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