Modified Nasolabial Transposition Flap Provides Vestibular Lining and Cover of Alar Defect With Intact Rim

Abstract

A 77-year-old woman was seen in consultation for evaluation of several basal cell carcinomas, one of which involved the left nasal ala. Resection of the basal cell carcinoma of the left ala resulted in a perforating wound measuring 3.10 × 2.5 cm. A strip of alar rim 0.2- to 0.3-cm wide was left intact. Various reconstruction options, as well as the possibility of a prosthesis were considered, and the following procedure was carried out. A superiorly based nasolabial flap was designed with sufficient length to provide both external cover and vestibular lining (Fig 1). In planning the procedure, the superior arcuate line was drawn across the flap such that incision of the flap at this point would provide a good fit in the primary defect. Then a second arcuate line was drawn 3 mm distal to the first, equaling the thickness of the alar rim. The flap was incised, elevated,