title: Reconstruction of the nasal infratip, columella, and soft triangle.
abstract: BACKGROUND
  Tumors of the soft triangle and distal nose are common, and the wounds created when removing them are among the more challenging defects to repair.
  
  
  OBJECTIVE
  Reconstruction of the soft triangle, infratip, and columella requires attention to form and function beyond what is usually needed in cutaneous surgery. The complexities of the anatomy demand meticulous planning and surgical execution. In this review, the goal is to provide the cutaneous surgeon with a logical approach to repair this challenging region.
  
  
  METHODS
  Skin grafts, composite grafts, local flaps, and pedicle flaps are presented with pearls and pointers. Cartilage grafting for stability is reviewed and detailed. A step-by-step approach allows the surgeon to plan appropriately and execute repairs with excellence.
  
  
  RESULTS
  Ten cases are reviewed in sequential photo format to demonstrate successful reconstruction of operative wounds from this challenging region of the nose.
  
  
  CONCLUSIONS
  The most distal nasal contours pose many challenges for reconstruction. Success depends on a good knowledge of anatomy, rigorous planning, and superior surgical skills. Skin grafts, composite grafts, local and interpolated flaps are all options that need to be considered when recreating the delicate folds and contours of this region. Cartilage support may be needed to maintain structural integrity. With care, excellent outcomes are predictably achieved.
authors.affiliation: Division of Dermatology, Fletcher Allen Health Care, University of Vermont College of Medicine, Burlington, Vermont.
authors.forename: Glenn D
authors.initials: GD
authors.lastname: Goldman
mesh_terms: D002356:Cartilage / Q000637:transplantation; D006801:Humans; D009300:Nasal Septum / Q000601:surgery; D009666:Nose / Q000601:surgery*; D009669:Nose Neoplasms / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012225:Rhinoplasty / Q000379:methods*; D016038:Skin Transplantation; D013524:Surgical Flaps; D014945:Wound Healing