title: A composite nasolabial flap for an entire ala reconstruction.
abstract: BACKGROUND
  It is difficult to reconstruct an entire alar defect. We report a case of an entire alar reconstruction carried out in two stages with a composite nasolabial flap lined with retroauricular skin and supported with the attached conchal cartilage.
  
  
  OBJECTIVE
  A composite nasolabial flap was applied for reconstruction of entire alar defect in this patient.
  
  
  METHODS
  The lining skin for the flap was obtained from retroauricular region acceptable to the patient, and the conchal cartilage was used simultaneously for support and as the attachment for the lining skin. The flap was then replaced and secured. Half a year later, the flap was flipped and transferred to the alar defect as a second step.
  
  
  RESULTS
  The final shape and texture were satisfactory. All procedures were performed under local anesthesia.
  
  
  CONCLUSIONS
  Our design of composite flap has been successfully utilized to repair an entire alar defect with cosmetically and functionally good results, minimizing the donor area and the resulting operation scars. This composite nasolabial flap is thought to be the best choice of a flap for an entire alar defect reconstruction.
authors.affiliation: Department of Dermatology, Surugadai Nihon University Hospital, Itabashi Nihon University Hospital, Tokyo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kakinuma
authors.forename: Utsugi
authors.initials: U
authors.lastname: Iwasawa
authors.forename: Michio
authors.initials: M
authors.lastname: Honjoh
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Koura
mesh_terms: D006801:Humans; D008297:Male; D008875:Middle Aged; D009666:Nose / Q000601:surgery*; D009669:Nose Neoplasms / Q000601:surgery*; D012225:Rhinoplasty / Q000379:methods*; D013524:Surgical Flaps