Correction of nasal tip deformity using an island flap of nasal dorsum

Abstract

Bifid nose is a rare congenital malformation, and few cases have been reported due to its low incidence. Herein, we report a new surgical procedure to treat patients with excess dorsal nasal tissue and an underfilled tip.A total of 22 patients with bifid nose deformities underwent surgery at our institution between 2012 and 2022. They were characterized by broad nasal dorsum and a missing or underdeveloped nasal tip. We designed an innovative island flap of nasal dorsum as a new surgical method for treating this type of bifid nose deformities. Nasal length, tip projection and photographs of nose morphology were obtained before and after the surgery. Outcomes, complications, indications and patient’s satisfaction were analyzed and interviewed.The follow-up time ranges from 6 to 33 months (8.7±5.5 months). The deformity was successfully corrected with improved nasal appearance. Nasal length increased from initially 4.2±0.3mm to 4.6±0.3mm. Tip projection reached to 19.9±4.0mm, which was 15.7±2.9mm before surgery. No serious complications were observed except poor venous reflux within postoperative 72hours in 4 cases. Six patients (27.3%) got moderate healing and acceptable scar, and 14 patients (63.6%) got good healing. Most patients were very satisfied with the outcome (93.9%).The newly designed nasal dorsum island flap is a safe and effective technical approach to correct nose deformity featured by broad nasal dorsum and a missing or underdeveloped nasal tip.