title: Alar reconstruction with subcutaneous pedicled nasolabial flap: difficulties, considerations, and conclusions for this procedure.
abstract: BACKGROUND
  The subcutaneous pedicled nasolabial flap is a useful material for alar reconstruction.
  
  
  OBJECTIVE
  This article describes the difficulties and considerations in this procedure and discusses the procedural problems involved, drawing conclusions from them.
  
  
  METHODS
  Case 1: a folded flap was used with a conchal cartilage strut sandwich. Case 2: only a folded flap was used. Case 3: the flap was used to cover the outer surface of the ala, and a mucoperiosteal graft from the hard palate was used for the ala lining.
  
  
  RESULTS
  The cartilage strut was not sufficient to support the shape of the ala in case 1. Harvesting a sufficiently wide flap is thought to be important. However, a folded flap had some drawbacks, with the formation of a thick alar rim.
  
  
  CONCLUSIONS
  The combination of a flap for the outer surface and a mucoperiosteal graft as a lining is thought to be an excellent option for alar reconstruction.
authors.affiliation: Department of Dermatology, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo 060-8638, Japan. mayamaya@viola.ocn.ne.jp
authors.forename: Fumiya
authors.initials: F
authors.lastname: Iwao
mesh_terms: D000368:Aged; D002280:Basal Cell Carcinoma / Q000601:surgery; D005145:Face / Q000098:blood supply*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery / Q000379:methods; D009669:Nose Neoplasms / Q000601:surgery; D012225:Rhinoplasty / Q000379:methods*; D013524:Surgical Flaps; D016896:Treatment Outcome