The Peng flap: reviewed and refined.

Background: The Peng flap was first described in 1987 and there has been only one subsequent article published about its use. The Peng flap is very versatile and has a greater range of application than previously described. It can be used for central and eccentric defects of the nasal tip and it is also an excellent choice for defects that bridge the proximal nasal tip with the distal dorsum.

Objective: In this series, we present several new modifications to the Peng flap.

Methods: We describe conceptual changes in the movement dynamics of the flap based on these design refinements. Additional detail regarding flap execution is provided.

Results: Presented here is retrospective data on the last 30 patients from our tumor registry who received Peng flap repairs between 2001 and 2006. The average defect size was 1.8 x 1.5 cm.

Conclusions: Described herein is a refined flap design that: (1) hides incisions in cosmetic junctions, (2) achieves a wider pedicle, and (3) utilizes a larger component of cheek advancement than previously described.