الفهرس 
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Abstract
SUMMARY
The face plays a central role in the daily interactions of a person through its expression of feelings, beauty, and identity. An individual’s self- image and self -esteem are often derived from his or her own facial appearance, any injury affecting those features requires particular attention. Facial defects can be caused by trauma or surgical excision of tumors. Traumatic facial soft tissue injuries are commonly encountered in the emergency department by plastic surgeons and other providers. These injuries account for nearly 10% of all emergency department visits when assessing statistics about the frequency of human cancers, one can read that breast, lung, prostate, and colorectal cancers affect millions of people every year. However, the most common neoplasms in humans are skin cancers: one in every three diagnosed malignancies is skin cancer; frequently, they localize on the face.
Despite the great advances in reconstructive surgery, it is difficult if not impossible to accurately reconstruct with autologous tissues. The body contains no tissues possessing the texture, pliability, and complexity of the face. There are various options for reconstruction of facial defects, starting with skin grafting which has its limits due to contractures, poor color and poor texture match. Also we have local flaps which are aesthetically ideal for small to moderate defects, but have restrictions due to limited mobility and availability of overlying skin and soft tissue, also bulkiness at the pedicle site, necessitating a delayed procedure. Free flap design and harvest are advanced techniques, so it is recommended that only microsurgeons experienced in the use of the hand-held Doppler for identifying cutaneous vessels and retrograde dissection of pedicles of conventional perforator flaps attempt them. They should be hardly trained for anastomosing such 1mm sized perforators.
With improvement in our knowledge of the anatomy of blood supply to the skin, the perforator flaps have opened a whole new horizon for the plastic surgeon to choose flaps for better function and cosmesis. The locally available perforators enable flaps to be designed with excellent match in tissue characteristics.
The aim of this study is to assess the role of perforator based flaps for cutaneous facial reconstruction from aesthetic and functional point of views on a scale of 30 patients.