title: A new technique for reconstruction of a congenital isolated alar defect.
abstract: Congenital isolated alar defect (CIAD) is an extremely rare anomaly causing a remarkable aesthetic deformity. Up to today, only 6 previous cases have been reported, and there has been no technique approved as a criterion standard for the reconstruction of this anomaly yet. Here, we present a patient with a wide unilateral CIAD reconstructed with a new procedure, namely Mutaf's triangular closure technique. A 16-year-old adolescent boy was admitted to our clinic with a CIAD of 1.4 cm x 1.8 cm located on the left side. The reconstruction of the defect was done in a 3-layered fashion. The skin defect was covered by using the Mutaf's triangular closure technique in which 2 cutaneous local flaps designed in an unequal Z-plasty manner were used. The mucosal closure was achieved with a single mucosal transposition flap elevated from the superolateral alar region. A septal cartilage graft was placed between the skin and mucosal closure to replace the missing part of the lower lateral cartilage. Flaps healed with no complication. At 1 year after surgery, there was a cosmetically and functionally excellent result with almost symmetrical nostrils and minimal scar formation. Providing an aesthetic and anatomic reconstruction with alike local tissues, Mutaf's triangular closure procedure seems to be a useful option for reconstruction of the CIADs.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Gaziantep University School of Medicine, Gaziantep, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Mutaf
authors.forename: Ertan
authors.initials: E
authors.lastname: Günal
mesh_terms: D000293:Adolescent; D002356:Cartilage / Q000637:transplantation; D004954:Esthetics; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D055171:Nasal Cartilages / Q000002:abnormalities* / Q000601:surgery; D009297:Nasal Mucosa / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D016038:Skin Transplantation / Q000379:methods; D013524:Surgical Flaps; D014945:Wound Healing / Q000502:physiology