Single-Stage Ala Nasi Reconstruction

Abstract

Since its first description, the nasolabial flap is one of the most preferred methods for the ala nasi reconstruction. Because of its similarity in skin color and texture to the nose, completely concealed scar in the nasolabial sulcus makes it a better choice. The major drawback of this flap is that it necessitates a 2-stage procedure. To gain more freedom in the reconstruction of alar defects, we planned to harvest a perforator flap around the nasolabial fold, which was the one of fixed areas, and included perforators from the lateral nasal artery that is a branch of the facial artery. Lateral nasal artery perforator flap was obtained from 8 patients who have them in the perialar region. Mean age was 64 years. Mean follow-up time was 18 months. In all patients, defects occurred after excision of basal cell carcinoma. All of them were verified histopathologically. In all patients, we identified a suitable lateral nasal artery perforator to meet our reconstructive demand. All defects that occurred were not suitable for primary closure, and sizes of all flaps were bigger than 1.5 cm in width and 1.5 cm in length. All of the flaps survived, and venous congestion was seen in the first 24 hours after operation, but this resolved without any partial or complete necrosis in 3 flaps. As another perforator flap, lateral nasal artery perforator flap can be adopted for defects in any fashion without any mobilizing restrictions. The lateral nasal artery perforator flap can be rotated 90 and 180 degrees as a propeller flap or can be transposed or advanced.