title: Superficial nasalis aponeurotic system (SNAS) flap reconstruction of nasal defects.
abstract: Reconstruction of full-thickness tissue loss of the nose, particularly in the nasal tip and supratip areas, remains a technical and aesthetic challenge. Exposure of the alar cartilage can complicate an already difficult reconstruction. Many method of reconstruction have been described. We offer an alternative to previously described techniques, utilizing the nasalis aponeurosis to provide alar coverage and bulk, in conjunction with full-thickness skin grafting to minimize contour deformity. The authors describe the technique and anatomy based on cadaveric dissection and its use in 4 patients. We have performed the superficial nasalis aponeurotic system (SNAS) flap on 4 patients with satisfactory aesthetic results. Use of the SNAS for coverage obviates the need for resection of a dog-ear, as may be the case with cutaneous or musculocutaneous flaps. Alar contour deformity is minimal. The SNAS flap is a useful technique to provide soft-tissue coverage of full-thickness soft tissue loss of the nose.
authors.affiliation: University of Pennsylvania Medical Center, Division of Plastic Surgery, Philadelphia 19104, USA.
authors.forename: D
authors.initials: D
authors.lastname: O'Hara
authors.forename: S
authors.initials: S
authors.lastname: Greenberg
authors.forename: D
authors.initials: D
authors.lastname: LaRossa
mesh_terms: D000328:Adult; D000368:Aged; D002280:Basal Cell Carcinoma / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D002356:Cartilage / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D009669:Nose Neoplasms / Q000601:surgery; D012086:Reoperation; D012225:Rhinoplasty / Q000379:methods*; D013524:Surgical Flaps / Q000379:methods*