The Central Facial Defect Reconstruction Using a Radial Forearm Free Flap after Malignant Cutaneous Tumor Ablation

Purpose: Acquired defects of the central face pose significant challenges in achieving acceptable cosmetic and functional outcomes. The site, size, and depth of tissue loss often render local tissues inadequate for the repair of major nasal defects. In this article, we aim to demonstrate the efficacy of radial forearm-free flaps as an ideal choice for various central facial unit reconstructions. Methods: This study encompassed patients treated between 2020 and 2022 who underwent facial reconstruction using radial forearm flaps. These flaps were employed in eleven patients with defects involving the lower lid, nose, upper lip, and lower lip. Additionally, we used osteocutaneous flaps in one patient to reconstruct a right nasal bone defect. In three patients requiring medial and lateral canthal tendon reconstruction in one case and oral sphincter reconstruction in two cases, the palmaris longus tendon was included with the flap. Results: In the majority of cases, we achieved good to excellent aesthetic and functional results. Notably, there were no instances of flap failure or partial necrosis in this series. All patients experienced uneventful healing at the donor site. Conclusions: The radial forearm-free flap stands as an ideal and reliable method for reconstructing various facial defects. It offers efficient and thin-conforming skin coverage.