This is an update from the authors that originally described the freestyle facial artery perforator flap for one stage nasal reconstruction in 2009. They now update with their 10-year experience of freestyle facial artery perforator flaps, accumulating a series of 21 patients (out of 86 nasal alar reconstructions) since 2004. Only one flap had minor congestion leading to flap tip necrosis. There is a good overview of the technique with an insight into its evolution and discussion of the relevant anatomy. Crucially they describe planning methodology and contraindications with the technique illustrated clearly with excellent photographs. They conclude that near total alar subunit or lateral alar defects are well served with this freestyle facial artery perforator flap reconstruction. This is good read for all surgeons interested in nasal reconstruction.

Reconstruction of nasal alar defects with freestyle facial artery perforator flaps.
D’Arpa S, Pirrello R, Toia F, et al.
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Sunil K Bhatia

Royal Shrewsbury Hospital, Shrewsbury, UK.

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