๐ ็ธฝ็ฎ้ ๏ฝ ๐ ่ฑๆๅๆ๏ผๆฌ็ฏ๏ผ ๏ฝ ๐ ๅฎๆด็ฟป่ญฏ ๏ฝ โญ ็ฒพ่ฏ็ญ่จ
Chin
Chin
The key advantage of all transposition flaps is reorientation of the tension vector. In a bilobed flap, the tension vector is not only reoriented, but also distant to the defect. This enables closure of the primary defect without any tension, making it a reliable solution for defects near any free margin. As such, the bilobed flap can be used on the chin without fear of displacing the lower lip or commissure, with the added benefit of bringing in matching skin with terminal hair. Undermining is performed within the midadipose plane, with special care taken along the mandible where the marginal mandibular nerve is located. After completion, the straight line from closure of the tertiary defect should lie along a relaxed skin tension line, such as the marionette fold. The point of the final lobe is tucked beneath the chin to avoid a standing cone deformity at the mandible that would unilaterally accentuate the jowl (Fig. 24-6).
Figure 24-6. Series of photos for bilobed flap on chin. Mohs defect (A), immediately postrepair (B), and 6 months postoperative (C).