Mustarde Cheek Advancement Flap: A Versatile and Robust Option to Resurface Infraorbital and Cheek Defects

Authors

  • Hajirah Khalid Department of Plastic Surgery, Shaheed Zulfiqar Ali Bhutto Medical University/PIMS Islamabad Pakistan
  • Abdul Khaliq Malik Department of Plastic Surgery, Shaheed Zulfiqar Ali Bhutto Medical University/PIMS Islamabad Pakistan
  • Rida Siddiqui Department of Plastic Surgery, Shaheed Zulfiqar Ali Bhutto Medical University/PIMS Islamabad Pakistan
  • Hijab Saeed Department of Plastic Surgery, Shaheed Zulfiqar Ali Bhutto Medical University/PIMS Islamabad Pakistan
  • Sanila Ayub Department of Plastic Surgery, Shaheed Zulfiqar Ali Bhutto Medical University/PIMS Islamabad Pakistan
  • Hassan Ahmad Department of Orthopedic Surgery, Shaheed Zulfiqar Ali Bhutto Medical University/PIMS Islamabad Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76iSUPPL-9.13633

Keywords:

Cheek Defects, Flap Loss, Infraorbital Defects, Mustarde Cheek Flap, Reconstruction

Abstract

Objective: To determine the outcomes of Mustarde cheek flap for reconstruction of infraorbital and cheek defects.

Study Design: Prospective observational study.

Place and Duration of Study: Pakistan Institute of Medical Sciences, Islamabad, Pakistan from Aug 2024 to Jan 2025.

Methodology: Sixty patients who presented with infraorbital and cheek defects were enrolled in the study and planned to undergo reconstruction of infraorbital and cheek defects by applying Mustarde’s flap. The primary outcome measure was success that was absences of any sort of complication and accurate placement of flap. SPSS version 22 was used to analyze the data.

Results: In this study, 60 patients were enrolled with median age of 40.00 (IQR:20.00) years. There were 28(46.7%) males and 32(53.3%) females. Out of 60 patients, success was achieved in 47(78.3%) cases without any complication. Out of 13 patients in whom complications were developed, sagging of the flap was noted in 8(61.5%) cases, ectropion of the lid margin in 2(15.4%) cases, hematoma 4(30.8%), infection 5(38.5%), distal flap necrosis 5(38.5%) cases, facial neve injury 2(15.4) cases and recurrence in 1(7.7%) patient.

Conclusion: Mustarde cheek flap was found to be effective and successful method for reconstruction of infraorbital and cheek flap.

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References

1. Başağaoğlu B, Bhadkamkar M, Hollier P, Reece E. Approach to Reconstruction of Cheek Defects. Semin Plastic Surg 2018; 32(2): 84-89. https://doi.org/10.1055/s-0038-1642640

2. Lian C, Zhang J-Z, Li X-L, Liu X-J. Reconstruction of a Large Oncologic Defect Involving Lower Eyelid and Infraorbital Cheek Using MSTAFI Flap. Ear Nose Throat J 2023; 102(4): 223-226.

https://doi.org/10.1177/01455613211000294

3. Patel PM, Greenberg JN, Kreicher KL, Burkemper NM, Bordeaux JS, Maher IA. Combination of melolabial interpolation flap and nasal sidewall and cheek advancement flaps allows for repair of complex compound defects. Dermatol Surg 2018; 44(6): 785-795. https://doi.org/10.1097/DSS.0000000000001471

4. Lian C, Li X-L, Liu X-J. Modified supratrochlear artery forehead island flap: a novel approach for 1-stage reconstruction of nasal defects. Ear Nose Throat J 2021; 100(5_suppl): 788S-789S.

https://doi.org/10.1177/0145561319900389

5. Donigan JM, Taylor O, Greif C, Srivastava D, Nijhawan RI. Inferiorly Based Rotation Flaps for Infraorbital Cheek Defects. Dermatol Surg 2022; 48(1): 61-66.

https://doi.org/10.1097/dss.0000000000003273

6. Derebaşınlıoğlu H. Distribution of skin cancers of the head and neck according to anatomical subunit. Eur Arch Oto-Rhino-Laryngol 2022; 279(3): 1461-1466.

https://doi.org/10.007/s00405-021-6901-7

7. Gillmor CL, Khan JA, Sokol JA. Upper eyelid malpositions: retraction, ectropion, and entropion. In: Albert D, Miller J, Azar D, Young LH, editors. Albert and Jakobiec's principles and practice of ophthalmology. Online: Elsevier; 2020. p. 1-24.

8. Lewin JM, Sclafani AP, Carucci JA. An inferiorly based rotation flap for defects involving the lower eyelid and medial cheek. Fac Plast Surg 2015; 31(04): 411-416.

https://doi.org/10.1055/s-0035-1562879

9. Patel SB, Buttars BR, Roy DB. Mustardé flap for primary nasal sidewall defect post-Mohs micrographic surgery. JAAD Case Rep 2022; 23: 151-154.

https://doi.org/10.1016/j.jdcr.2022.03.014

10. Salzano G, Maffìa F, Vaira LA, Committeri U, Copelli C, Maglitto F, et al. Locoregional Flaps for the Reconstruction of Midface Skin Defects: A Collection of Key Surgical Techniques. J Clin Med 2023; 12(11): 3700.

https://doi.org/10.390/jcm12113700

11. Jain A, Saini N, Kapoor Y, Gole G. Mustade's flap for post basal cell carcinoma excision lower eyelid reconstruction: our experience. J Evid Based Med Healthcare 2015; 2: 3924-3928.

https://doi.org/10.18410/jebmh/2015/555

12. Stewart K, Burkat CN. Eyelid and periorbital reconstruction. Albert and Jakobiec's Principles and Practice of Ophthalmology: Springer; 2022: 5573-5608.

13. Guo K, Li M, Qi J, Han S, Wu X, Guo F. Precise Maxillofacial Soft Tissue Reconstruction: A Combination of Cone Beam Computed Tomography and 3dMD Photogrammetry System. Heliyon 2024; 10(12): e32513.

https://doi.org/10.1016/j.heliyon.2024.e

14. Sugg KB, Cederna PS, Brown DL. The V-Y advancement flap is equivalent to the Mustardé flap for ectropion prevention in the reconstruction of moderate-size lid-cheek junction defects. Plast reconstr surg 2013; 131(1): 28e-36e.

https://doi.org/10.1097/PRS.0b013e3182729e22

15. Ozgur O, Kothapudi VN, Campos MBS, Rostami S. Lower Eyelid Reconstruction. Treasure Island (FL): StatPearls Publishing; 2025.

16. Rhodes R, Moreau A, Romano E, Cannon T. The cervicofacial flap. Oper Tech Otolaryngol Head Neck Surg 2019; 30(2): 145-150. https://doi.org/10.1016/j.otot.2019.04.010

17. Shetawi AHA, Wing W. Reconstruction of Head and Neck Melanoma. In: Fernandes RP, Shetawi AHA, editors. Management of Melanoma of the Head and Neck. Oral Maxillofac Surg Clin North Am. Philadelphia(PA): Elsevier; 2022 p. 283.

18. Ehrenfeld M, Cornelius C-P. Pedicled Flaps. Oral and maxillofacial surgery: Surgical textbook and atlas: Springer; 2023. p. 641-715.

19. Patel SB, Buttars BR, Roy DB. Mustard flap for primary nasal sidewall defect post-Mohs micrographic surgery. JAAD Case Rep 2022; 23: 151-154.

https://doi.org/10.1016/j.jdcr.2022.03.014

20. Caimi E, Balza A, Vaccari S, Bandi V, Klinger F, Vinci V. Optimizing postoperative care in rhinoplasty and septoplasty: a review of the role of nasal packing and alternatives in complication management. Aesth Plast Surg 2024; 48(15): 2812-2817. https://doi.org/10.1007/s00266-024-3907-4

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Published

30-09-2026

How to Cite

1.
Hajirah Khalid, Abdul Khaliq Malik, Rida Siddiqui, Hijab Saeed, Sanila Ayub, Hassan Ahmad. Mustarde Cheek Advancement Flap: A Versatile and Robust Option to Resurface Infraorbital and Cheek Defects. Pak Armed Forces Med J [Internet]. 2026 Sep. 30 [cited 2026 Oct. 6];76(SUPPL-9):S1458-S1462. Available from: https://www.pafmj.org/PAFMJ/article/view/13633