6533b85ffe1ef96bd12c0ffb

RESEARCH PRODUCT

Expanded forehead (Fricke) flap for large defect of lateral canthal area

subject

description

The use of an expanded forehead (Fricke) flap to repair large full thickness defects of the lateral canthus and/or of the upper eyelid is presented. The reconstruction is performed in two stages. In the first stage, a rectangular, 25 ml tissue expander (6 cm in width and 2 cm in length) is inserted under the skin lateral to and above the eyebrow; expansion is completed in about three weeks. At the second stage, the lesion is excised, and the laterally based expanded flap is elevated. Using the expanded Fricke flap, thinner, abundant skin is obtained, and the donor site is directly closed, without grafting and without distorting the eyebrow. If there is a shortage of conjunctiva, this can be reconstructed with the capsule of the expanded flap. The result is functionally and aesthetically satisfactory. This technique has been used on six patients following tumour resection in the lateral canthal area. This method is proposed as an alternative to other flaps, which can be used to reconstruct the lateral canthus, and which often gives unsatisfactory final results.