Crab-pincers style facial artery flap.

To reconstruct defects as large as 5 cm in diameter in the region extending from the columella and anterior nasal floor to the upper lip, we use a crab-pincers style facial artery (CPFA) flap technique combining nasolabial flaps and cheek advancement flaps. In the CPFA flap, the bifurcation of the facial artery allows the angle between the nasolabial flap and the cheek advancement flap to be freely altered in the manner of crab pincers. By combining the four leaves of bilateral CPFA flaps at the centre, appropriate reconstruction of the three-dimensional structures surrounding the columella can be achieved. In addition, this method requires only one operation to complete extensive reconstruction. The method does not result in adverse scarring or scar contracture. After the procedure,appropriate moustache growth gives a natural impression and conceals philtral distortion. We consider the CPFA flap to be very useful for reconstructing large defects in the central facial region.