Freestyle facial perforator flaps—a safe reconstructive option for moderate-sized facial defects

BACKGROUND: Perforators are a constant anatomical finding in the facial area and any known flap can in theory be based on the first perforator located at the flap rotation axis. METHODS: A case series of single stage reconstruction of moderate sized facial defects using 21 perforator based local flaps in 19 patients from 2008–2013. RESULTS: A sufficient perforator was located in every case and the flap rotated along its axis (76 %) or advanced (24 %). Reconstruction was successfully achieved with a high self reported patient satisfaction. Two minor complications occurred early on in the series and corrective procedures were performed in four patients. CONCLUSIONS: The random facial perforator flap seems to be a good and reliable option for the reconstruction of facial subunits, especially the periorbital, nasal and periocular area with a minimal morbidity and a pleasing result in a one stage outpatient setting. Level of Evidence: Level IV, therapeutic study