Abstract
Trilobed flaps: an alternative to dorsal nasal flaps
Highlights
Partial thickness nasal defects on the tip, supratip, and lateral tip pose unique reconstructive challenges, and have been approached successfully with a variety of surgical techniques
The repair comes at the cost of lengthy suture lines, ideally hid along the nasofacial sulcus and in the glabella, but always with an oblique distal nasal suture line at the site of standing cone repair
Alar asymmetry and tip elevation remain possible complications, these are usually prevented with proper patient selection, flap design and surgical execution
Summary
Partial thickness nasal defects on the tip, supratip, and lateral tip pose unique reconstructive challenges, and have been approached successfully with a variety of surgical techniques. The dorsal nasal (Reiger) rotation flap [1] is a widely used reconstruction that preserves distal nasal contour as a sliding flap, with elements of both rotation and advancement, accessing the reservoir of lax dorsal nasal and glabellar skin. The repair comes at the cost of lengthy suture lines, ideally hid along the nasofacial sulcus and in the glabella, but always with an oblique distal nasal suture line at the site of standing cone repair. When designed and executed correctly, the results are elegant, and often a preferred alternative to a skin graft or other local flaps. Alar asymmetry and tip elevation remain possible complications, these are usually prevented with proper patient selection, flap design and surgical execution
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