Reconstruction of the nose utilizing a bilobed flap.
BACKGROUND
Defects of the distal nose are particularly challenging to reconstruct because of this area's unique texture, lack of elasticity, and possible distortion of the alar rim. The bilobed flap has been criticized for having a high incidence of "trapdooring," flap necrosis, dog ears, and prominent suture lines.


METHODS
Patients who underwent bilobed flap repairs of the distal nose (n = 171) were reviewed for complications and cosmetic results. The modifications from the traditional design include minimizing the angle of transposition between lobes, thinning of the flap, basing the pedicle on the lateral aspect of the nose, and creating the lobes of the flap to be of equal diameter to the defect.


RESULTS
There was a 3% incidence of infection, 7% incidence of partial flap necrosis, and 5% incidence of "trapdooring" and contour distortion. Color match and contour were excellent for all other patients.


CONCLUSIONS
The modified bilobed flap is an excellent choice for reconstruction of defects of the lower nose because of the good skin match and low incidence of complications.
Moy
R L
RL
UCLA Division of Dermatology, VA-Wadsworth Medical Center.
Grossfeld
J S
JS
Baum
M
M
Rivlin
D
D
Eremia
S
S
D006801:Humans; D015580:Mohs Surgery; D009666:Nose / Q000601:surgery; D009669:Nose Neoplasms / Q000601:surgery*; D011183:Postoperative Complications; D013524:Surgical Flaps / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome