The authors present a series of 25, mainly geriatric patients that had ablative surgery with complex defects in the paranasal and orbital regions. The paranasal and periorbital regions are extremely important for facial aesthetics and quality of life. The authors describe a contralateral cranial based nasolabial flap for complex full thickness defects. The advantages of the flap are a thin and pliable flap, good aesthetic matching, minimal donor site morbidity, reliability and resilience of the flap and single stage closure of the defect. There are very good colour photographs that show the various stages. The surgical technique is very sparingly described and will require further reading prior to attempting this flap. In older patients this would be a very useful alternative to free flap reconstruction.

The cranially based contralateral nasolabial flap for reconstruction of paranasal and periorbital surgical defects.
Kerem H, Bali U, Sönmez E, et al.
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Sunil K Bhatia

Royal Shrewsbury Hospital, Shrewsbury, UK.

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