title: Nasolabial-alar crease: a natural line to facilitate transposition of the nasolabial flap for lower nasal reconstruction.
abstract: BACKGROUND
  Nasolabial flaps have been widely used for nasal reconstruction. However, transposition of the nasolabial flap to lower nasal defects may be challenging because of functional and aesthetic concerns. The upper part of the alar crease joins with the nasolabial fold seamlessly, forming the nasolabial-alar crease line, which provides a natural strategy for easy concealment of the surgical scar. In this article, we would like to introduce a method for transferring a nasolabial flap along the nasolabial-alar crease to reconstruct lower nasal defects.
  
  
  METHODS
  Incision was made along the nasolabial-alar crease, and the nasolabial flap was transferred for lower nasal reconstruction in 9 patients. Subcutaneously based nasolabial flaps were designed, and undermining of the superolateral skin was made along the nasolabial-alar crease to obtain a robust subcutaneously based pedicle, so as to readily achieve flap transposition without tension and concealment of the subcutaneous pedicle. The nasolabial fold could be reproduced by closing the donor site.
  
  
  RESULTS
  Lower nasal defects were successfully repaired with nasolabial flap in 9 patients. Good nasal contour and appropriate symmetry of the reconstructed nasolabial fold were achieved, and there were no conspicuous scars in the 9 cases.
  
  
  CONCLUSIONS
  The natural nasolabial-alar crease can serve as a useful incision line to facilitate the nasolabial flap transposition for lower nasal reconstruction while minimizing the scar.
authors.affiliation: From the Department of Plastic Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Hongda
authors.initials: H
authors.lastname: Bi
authors.forename: Xin
authors.initials: X
authors.lastname: Xing
authors.forename: Junhui
authors.initials: J
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D002280:Basal Cell Carcinoma / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005260:Female; D006801:Humans; D008046:Lip / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009666:Nose / Q000601:surgery; D009669:Nose Neoplasms / Q000601:surgery*; D012225:Rhinoplasty / Q000379:methods*; D012878:Skin Neoplasms / Q000601:surgery*; D013524:Surgical Flaps; D016896:Treatment Outcome