The orbicularis oculi muscle (OOM) is sometimes incorporated with the superficial musculoaponeurotic system (SMAS) flap to provide a stronger flap. While elevating the OOM flap, it is important to avoid injury to the orbicularis branches of the zygomatic nerve. When the orbicularis branches of the zygomatic nerve are identified during the OOM-SMAS flap elevation, a transverse OOM flap was created to preserve the nerve. Postoperative follow-up was 12 months. There was no functional impairment of the OOM in the follow-up period. There are anatomical variations of the orbicularis branches of the zygomatic nerve. When it is identified, a transverse OOM flap incorporating it can be raised to avoid inadvertent injury. Using this method, good results were achieved with virtually no complications.
From the *The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, Beijing, China
†Cara Plastic Surgery and Laser Center, Los Angeles, Calif.
‡Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Published online 4 October 2018.
Received for publication May 31, 2018; accepted August 7, 2018.
Disclosure: The authors have no financial interest to declare in relation to the content of this article. The Article Processing Charge was paid for by the authors.
Min-Hee Ryu, MD, Department of Plastic Surgery, The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, Beijing, China, No. 109 Nongguangli, Chaoyang District, Beijing City, China 100021, E-mail: firstname.lastname@example.org
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