Versatility of the Modified Limberg Flap in Facial Reconstruction: Indication and Technical Considerations

Background: Unlike other small to medium-sized skin and soft tissue defects, facial defects face significant constraints on reconstruction due to the limited availability of nearby skin, the necessity to preserve the integrity of surrounding structures, and the paramount focus on achieving optimal aesthetics and minimal scarring. We present a new modified Limberg flap and analyze the surgical outcomes of patients who underwent reconstruction using this technique.Methods: We conducted a retrospective chart review of patients who underwent wide excision and subsequent reconstruction using the modified Limberg flap between October 2020 and December 2022 at our institution. We analyzed patients’ sex, age, lesion characteristics (location and size), type of lesion, complications, recurrence, and scar satisfaction (visual analog scale score).Results: In total, 28 surgical procedures were performed on 26 patients. A total of 18 patients were followed up for 6 months postoperatively. There were 16 cases of skin cancer and two cases of benign tumors, with the most frequent locations being the cheek, periauricular area and nose. Three postoperative complications were found, including one case of marginal partial necrosis of the flap and two hematomas. Among patients who underwent resection of malignant tumors, residual tumor was detected in one case, necessitating additional excision and flap repositioning. Mean visual analog scale score with respect to scar outcomes after surgery was 3.6.Conclusion: The modified Limberg flap can offer a viable option for covering facial skin defects measuring 2–4 cm. This approach minimizes deformities of surrounding structures and is considered a relatively satisfactory aesthetic choice.