title: Reconstruction of large nasal defects with a combination of local flaps based on the aesthetic subunit principle.
abstract: Herein is described a technique that uses a combination of local flaps to reconstruct large defects involving the nasal dorsum and cheek. The flaps used are a transposition flap elevated from the area adjoining the defect and bilateral cheek advancement flaps. This technique leaves all suture wounds at borders of the aesthetic subunits that have been described previously. Color and texture matches were good and symmetrical. The transposition flap can be modified according to whether the defect includes the nasal tip. After raising the cheek advancement flap, it is also possible to use a dog-ear on the nasolabial region for any alar defects. Nine patients were treated using this procedure. The technique is very reliable (no complications such as congestion and skin necrosis in our series) and is easy to perform. One patient had palpebral ectropion after the operation and underwent secondary repair. In this series, defects measuring 45 x 30 mm in maximum diameter and including the nasal dorsum, nasal tip, ala, and cheek were treated.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Hirosaki University School of Medicine, Hirosaki, Japan. yotsu@cc.hirosaki-u.ac.jp
authors.forename: T
authors.initials: T
authors.lastname: Yotsuyanagi
authors.forename: K
authors.initials: K
authors.lastname: Yamashita
authors.forename: S
authors.initials: S
authors.lastname: Urushidate
authors.forename: K
authors.initials: K
authors.lastname: Yokoi
authors.forename: Y
authors.initials: Y
authors.lastname: Sawada
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D002280:Basal Cell Carcinoma / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D004954:Esthetics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009669:Nose Neoplasms / Q000601:surgery*; D019651:Plastic Surgery Procedures; D012878:Skin Neoplasms / Q000601:surgery*; D013524:Surgical Flaps