Two-stage correction of depressed glabella and nasal root scar contracture utilizing subcutaneous tissue advancement flaps and a layered soft tissue/procerus muscle transposition flap.
BACKGROUND
A postoperative nasal root and glabellar forehead deformity comprised both vertical and horizontal elements, with scar contracture and fixation across the left medial nose base, extending into the adjacent superior canthal region.


METHODS
A two-stage reconstruction was performed, initially correcting the vertical centrally placed forehead depression by dual subcutaneous flaps advanced centrally and joined. The horizontal nasal root contracture was repaired at a second stage utilizing a procerus muscle transposition flap elevated on the ipsilateral deep contracture side, imbricated in serpentine fashion on itself and sutured into the depression over the scar base.


RESULTS
Significant improvement followed.


CONCLUSIONS
The careful and precise placement of subcutaneous tissue and muscle can serve to assist in filling certain deep defects and in elevating scar lines.
Field
L M
LM
Department of Dermatology, University of California, San Francisco.
D000368:Aged; D002280:Basal Cell Carcinoma / Q000601:surgery; D002921:Cicatrix / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D009666:Nose / Q000601:surgery*; D009669:Nose Neoplasms / Q000601:surgery; D011183:Postoperative Complications / Q000601:surgery*; D012086:Reoperation; D013524:Surgical Flaps / Q000379:methods*; D016896:Treatment Outcome