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Cutaneous Reconstruction of the Nasal Distal Third: Alternative Local Flaps for a Complex Region.
Plast Reconstr Surg Glob Open
May 2021
the Department of Dermatology, Duke University Health System, Durham, N.C.
Small-to-medium cutaneous defects of the distal nose pose a significant challenge to reconstructive surgeons, and commonly described reconstructive techniques have their limitations. As the skin of this region is characteristically rigid and sebaceous, care must be taken to avoid introducing unfavorable tension vectors that can result in functional or anatomic distortion of the nasal free margins. With this in mind, the authors discuss 3 alternative reconstructive options, the East-West, nasalis sling, and trilobed flaps, which have wide utility in the repair of distal nasal cutaneous defects and can result in excellent cosmesis.
View Article and Find Full Text PDFCrescentic Modification to Island Pedicle Rotation Flaps for Defects of the Distal Nose.
Dermatol Surg
September 2019
Division of Dermatology, Department of Medicine, University of Vermont Medical Center, Burlington, VT.
Background: Island pedicle flaps based on a lateral sling of the nasalis have difficulty reaching distal nasal defects due to tethering of the muscle to its insertion point. The authors hypothesized that reach could be improved by modifying a crescentic flap to rotate around a pivot point equidistant to the flap and the defect.
Objective: To describe the design, execution, and results with a modified crescentic island pedicle rotation flap for repair of distal nasal defects after Mohs micrographic surgery.
Use of the Nasalis Sling Flap to Resurface Full-Thickness Defects of the Soft Triangle.
Dermatol Surg
October 2019
Department of Dermatology, University of Minnesota, Minneapolis, Minnesota Department of Dermatology, Saint Louis University St. Louis, Missouri Department of Dermatology, University of Minnesota, Minneapolis, Minnesota.
Modified single-sling myocutaneous island pedicle flap: series of 61 reconstructions.
Dermatol Surg
November 2008
Oregon Health and Science University, Portland, OR 97239, USA.
Background: Bilevel undermining above and below the transverse nasalis muscle in the construction of a myocutaneous island pedicle flap produces a bilateral or unilateral muscular sling with exceptional vascular supply for reconstruction of defects on the distal nose. We present further modification of the single-sling myocutaneous island pedicle flap that expands its application to a wide variety of nasal defects and further defines its usefulness in nasal reconstruction.
Methods: A series of 61 consecutive myocutaneous island pedicle flap reconstructions performed after Mohs surgery between March 2005 and July 2006 are presented.
The deformities of the lip and nose in cleft lip patients are intimately inter-related and their repair should not be independent procedures. The reconstruction should be dynamic, taking into account the different functions of the groups of the perioral musculature. For the lip repair, attenuation of the musculus nasalis of the sound side and the formation of the levator sling are believed to be important.
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