key: cord-0939149-2m9nzktb
authors: Hallock, Geoffrey G.
title: The COVID-19 facemask: Friend or foe?
date: 2020-12-15
journal: J Plast Reconstr Aesthet Surg
DOI: 10.1016/j.bjps.2020.12.034
sha: d5f9a820fef1d38c01c88c71e1b15ad5ef84522c
doc_id: 939149
cord_uid: 2m9nzktb

nan

The COVID-19 facemask: Friend or foe?

Dear Sir, Few would disagree that the global COVID-19 pandemic has been the "Great Disruptor. 1 " All of us have had to postpone elective cases unless there would be a significant potential for future morbidity or mortality. 2 To slow the spread and minimize the impact, society recommendations are that all "providers should wear personal protective equipment, including a minimum of face masks and face shields for all patients. 2 " In spite of these guidelines, we must still be the innovators and the leaders typical for our specialty for maximizing risk/benefit solutions for those other problems that have not taken a vacation. This is exemplified by a "routine" case where cartilage exposure of the nasal tip and columella followed Moh's surgical excision of a sebaceous carcinoma. Coverage using a standard median forehead interpolation flap appeared totally perfused 2 days postoperative. However, a week later the patient arrived for suture removal now wearing his protective face mask ( Figure 1 ). When unveiled, the distal half of the flap was non-viable ( Figure 2 ), obeying Vasconez's Second Law: "All of the flap will survive except the part that you need. 3 " Adjustment of eyeglasses from the nasal bridge always is advised to prevent forehead flap pedicle compression, 4 but today we must remember that a mask must also be adjusted to eliminate pressure on the inset flap itself or perhaps use a face shield as a substitute. Complications take no holiday; and in spite of the COVID-19 crisis, we must still be the problem solvers-it is indeed our responsibility! 5 .

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