Abstract

A 67-year-old man presented to our plastic surgery clinic with an ulcerating and enlarging mass over the left medial canthal region and bridge of the nose, which had developed rapidly. The mass was pathologically diagnosed as a basal cell carcinoma. After removal of the tumor with a 6-mm safety margin, the defect occupied a complex and wide defect extending from left medial canthal region to left nasal sidewall and root of the nose. We provided reconstruction of the defect by using a nasolabial perforator flap based on two vascular pedicles. Immediate venous return problem occurred after a couple of hours which got worse by the hour until no capillary refill could be seen. No surgical intervention was made apart from wishful waiting and the patient was discharged with oral antibiotics and local antibiotic ointment as wound care. At post-op 7th day, the flap was seen to suffer just marginal superficial de-epithelialization. During weekly follow-up flap was healed completely with no loss and a good cosmetic outcome.