Nasalis Flap and Graft Repair Provides Reliable Closure for Denuded Defects of the Nose

Abstract

Skin cancer surgery involving the nasal tip and dorsum sometimes results in exposure of underlying bone or cartilage. We describe a simple method of providing a vascular bed for the defect using the superficial nasalis musculoaponeurotic system (SNAS) of the nose, which allows full-thickness skin graft reconstruction of the defect and an acceptable cosmetic outcome. The utility of nasalis flaps to provide a vascular bed for grafting has not been specifically addressed in the dermatology literature. Our experience with 26 SNAS flaps is outlined to demonstrate the utility of this closure in the appropriate situations. A discussion of the relevant anatomy is followed by an outline of the surgical technique. SNAS flaps provide a reliable vascular bed and contour for defects of the bridge and distal nose. Complications have been few. The SNAS flap and graft are simple to perform and provide a reliable alternative to interpolated nasolabial or forehead flaps when the defect exposes significant bare cartilage or bone.