The Bilobed Flap in Nasal Repair

Abstract

Surface defects resulting from excision of nasal lesions are commonly repaired by direct primary closure, skin grafts, or pedicle flaps. An effective but seldom used bilobed adjacent flap described by Esser and Zimany deserves increased attention in nasal reconstruction. This flap design possesses the following virtues: (1) Primary nondelayed transposition, (2) excellent color match, (3) primary closure of donor site, (4) one-stage repair, and (5) minimal tissue distortion. Zimany described the bilobed flap as one consisting of two lobes separated by more or less of an angle and based upon a common pedicle. The glabellar and nasolabial area serve as an abundant resource for tissue donation in nasal defect repair, without significant residual donor site deformity. The secondary donor site of the bilobed flap is effectively camouflaged in a natural skin fold or wrinkle, creating no significant facial deformity and providing a cosmetically superior repair.