Single-stage reconstruction of a full-thickness alar defect using a folded nasolabial flap combined with a redundant skin turnover flap.
BACKGROUND
The reconstructive strategy for full-thickness nasal skin defects should include recreation of a cutaneous cover, support, and internal nasal lining. The most challenging aspect of this procedure is provision of the nasal lining. These reconstructions typically require a 2-step process. Satisfactory nasal skin reconstruction in a single operation is ideal.


OBJECTIVE
We used a folded nasolabial flap combined with a turnover flap for reconstruction of full-thickness alar defects.


METHODS
The donor material of the lining flap was a combination of the distal portion of the nasolabial flap and redundant skin resected during its transposition. The redundant skin flap was turned upside down, with the skin surface inside the nasal cavity. The remaining portion of the defect was covered with a folded nasolabial flap.


RESULTS
This procedure was successful in all 5 patients. All flaps survived completely without evidence of necrosis or narrowing of airways. Aesthetic concerns, including effacement of the nasofacial sulcus, were minor.


CONCLUSIONS
This method has the advantage of providing well-vascularized tissue of appropriate color, texture, and thickness for external coverage, as well as a satisfactory internal lining in a single-stage procedure.
From the Department of Plastic and Aesthetic Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
Akira
A
Takeda
Minekatsu
M
Akimoto
Keiichi
K
Park
Natsuko
N
Kounoike
Yasuhito
Y
Shimakura
Mitsuru
M
Nemoto
Eiju
E
Uchinuma
D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D004954:Esthetics; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D055171:Nasal Cartilages / Q000601:surgery*; D009296:Nasal Cavity / Q000601:surgery; D009669:Nose Neoplasms / Q000601:surgery; D012225:Rhinoplasty / Q000379:methods*; D012867:Skin / Q000033:anatomy & histology; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps / Q000637:transplantation*