The flap remains connected to a vascular pedicle while it is elevated, preserving blood flow through vessels commonly supplied by branches of the facial artery. This connection allows the transferred skin and subcutaneous tissue to remain viable after repositioning. Maintaining the pedicle is therefore central to achieving durable coverage of the reconstructed defect.
Design must account for the defect’s location and the amount of tissue required for coverage. Skin and subcutaneous tissue from the fold can provide a relatively well-matched surface for nearby facial structures, while careful planning helps maintain facial symmetry. Appropriate design also reduces the likelihood of visible donor-site deformity after closure.
The donor region lies close to the nose, cheek, lips, and oral cavity, so the flap can reach these structures without requiring tissue from a distant site. This proximity supports reconstruction of small to moderate defects with tissue that is suited to the surrounding facial area. The donor site is also relatively concealed within the fold.
After the tissue is elevated with its vascular pedicle preserved, the flap is moved into the defect by rotation or advancement. Rotation redirects the tissue around the pedicle, whereas advancement moves it forward into the recipient area. The selected movement depends on the defect and flap design, with the goal of providing stable coverage.
The technique may be considered for small to moderate soft-tissue defects involving the nose, cheek, lips, or oral cavity. Such defects can result from tumor removal, trauma, or congenital abnormalities. Its regional location and available tissue make it particularly relevant when reconstruction requires nearby coverage while maintaining facial contour and symmetry.
Assessment should include whether the defect has durable soft-tissue coverage and whether the reconstructed area remains visually compatible with adjacent facial tissue. Facial symmetry is another important outcome because flap design affects contour. The donor fold should also be examined for deformity, since preserving a relatively concealed and well-designed donor site is part of the reconstructive objective.