title: Alar rotation flap for small defects of the ala.
abstract: BACKGROUND
  Surgical defects of the alar lobule can be difficult to repair with aesthetically pleasing results. Full-thickness skin grafts are often smoother than the sebaceous skin of the ala. Random patterned flaps from the cheek or proximal nose usually bridge and obliterate the supra-alar crease and may cause nasal valve malfunction.
  
  
  OBJECTIVE
  We describe and illustrate a technique to repair subtotal alar lobule defects within the cosmetic unit of the alar lobule.
  
  
  METHODS
  Twenty-three consecutive alar lobule rotation flaps for repair of Mohs surgical defects were reviewed by patient examination and interview.
  
  
  RESULTS
  Twenty-one of 23 patients were contacted. Patients rated cosmetic results as excellent (18), good (2), or fair (1), and no patients graded their results as poor. Six patients reported "a little" breathing difficulty in the postoperative period that resolved within 6 months. Anesthesia reported by 11 of 21 patients resolved within 5 years in 8 of 9 patients available for follow-up.
  
  
  CONCLUSIONS
  Rotation of the ala combined with cheek advancement is a cosmetically pleasing and functional method to repair deep defects of the ala.
authors.affiliation: Department of Dermatology, Geisinger Medical Center, Danville, Pennsylvania 17822, USA.
authors.forename: S A
authors.initials: SA
authors.lastname: Neltner
authors.forename: C A
authors.initials: CA
authors.lastname: Papa
authors.forename: M L
authors.initials: ML
authors.lastname: Ramsey
authors.forename: V J
authors.initials: VJ
authors.lastname: Marks
mesh_terms: D006801:Humans; D015580:Mohs Surgery / Q000534:rehabilitation; D009669:Nose Neoplasms / Q000601:surgery*; D017060:Patient Satisfaction; D012225:Rhinoplasty / Q000379:methods*; D013524:Surgical Flaps