title: The staged cheek-to-nose interpolation flap for reconstruction of the nasal alar rim/lobule.
abstract: BACKGROUND
  A deep defect of the nasal alar rim or lobule may represent a unique and difficult challenge because of the lax free margin and structural support supplied by the alar rim and lobule. Traditional closure strategies, including granulation, full thickness skin grafting, or nasolabial transposition flaps may result in unsatisfactory cosmetic and functional outcomes.
  
  
  OBJECTIVE
  This article describes our experience with the staged cheek-to-nose interpolation flap for repairing deep skin cancer excision defects of the nasal alar rim and lobule.
  
  
  METHODS
  The staged cheek-to-nose interpolation flap was used immediately after Mohs micrographic surgery to repair 18 deep nasal alar rim/lobule defects. In 13 patients, a free cartilage graft was used to restore structural support.
  
  
  RESULTS
  The cosmetic and functional outcomes of each repair were judged from good to excellent by patient and surgeon. No cases of infection or flap necrosis occurred. To enhance the cosmetic outcome, three patients underwent spot dermabrasion within 2 months after flap detachment.
  
  
  CONCLUSIONS
  The staged cheek-to-nose interpolation flap, with or without free cartilage grafts, consistently provides good to excellent cosmetic and functional outcomes when performed on properly selected deep nasal alar rim/lobule defects.
authors.affiliation: University of Michigan Medical Center and Comprehensive Cancer Center, Department of Dermatology, Ann Arbor 48109-0314, USA.
authors.forename: D J
authors.initials: DJ
authors.lastname: Fader
authors.forename: S R
authors.initials: SR
authors.lastname: Baker
authors.forename: T M
authors.initials: TM
authors.lastname: Johnson
mesh_terms: D002356:Cartilage / Q000637:transplantation; D002610:Cheek / Q000601:surgery*; D003097:Collateral Circulation; D003869:Dermabrasion; D004954:Esthetics; D005500:Follow-Up Studies; D006085:Graft Survival; D006097:Granulation Tissue / Q000473:pathology; D006801:Humans; D008046:Lip / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D015580:Mohs Surgery / Q000534:rehabilitation; D009336:Necrosis; D009666:Nose / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D009669:Nose Neoplasms / Q000534:rehabilitation / Q000601:surgery*; D017060:Patient Satisfaction; D012878:Skin Neoplasms / Q000534:rehabilitation / Q000601:surgery*; D016038:Skin Transplantation / Q000379:methods; D013524:Surgical Flaps / Q000098:blood supply / Q000145:classification / Q000473:pathology / Q000502:physiology; D013530:Surgical Wound Infection / Q000517:prevention & control; D016896:Treatment Outcome