Small Cheek Defects

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Small defects are repaired with transposition or rotation flaps, and small bilobed flaps can also be used (see pp. 6, 13-17, 22; Figs. 3.1b and 3.22). Defects in the nasal flank area can be closed by a Burow-type cheek advancement with a Burow's triangle (Fig. 8.3) or by excising a skin crescent in the nasolabial angle (see Fig. 8.4).

Cheek Flap
Fig. 8.2 Cheek reconstruction combining the Esser and Imre techniques (Weerda 1980). A crescent-shaped excision in the nasolabial fold is added to the Esser rotation (see Fig. 8.1). The flap is mobilized in the fat plane to avoid facial nerve injury (see Fig. 9.10).
Weerda Cheek Reconstruction

Fig. 8.1 Esser cheek rotation (1918). The flap is cut somewhat higher in the temporal area to provide excess tissue at the lower lid (to prevent ectropion). It is fixed to the periosteum of the orbital rim, and the cheek skin is mobilized (sparing the branches of the facial nerve).

Weerda Cheek Reconstruction

a Burow's cheek advancement. b The scars are located in the nasal flank and nasolabial fold (see Fig. 5.22).

a Burow's cheek advancement. b The scars are located in the nasal flank and nasolabial fold (see Fig. 5.22).

a Modified Imre cheek advancement.

b The scars are located at the boundaries of the esthetic units and in the RSTLs (nasolabial fold) (see Fig. 9.10).

a Modified Imre cheek advancement.

b The scars are located at the boundaries of the esthetic units and in the RSTLs (nasolabial fold) (see Fig. 9.10).

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