These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


PUBMED FOR HANDHELDS

Search MEDLINE/PubMed


  • Title: Flap or graft: The best of both in nasal ala reconstruction.
    Author: Lindsay KJ, Morton JD.
    Journal: J Plast Reconstr Aesthet Surg; 2015 Oct; 68(10):1352-7. PubMed ID: 26188401.
    Abstract:
    UNLABELLED: The area of the nose immediately medial to the nasofacial groove is a common site for relatively small but penetrating basal cell carcinomas (BCCs). Although larger lesions may necessitate formal subunit reconstruction, smaller lesions pose a considerable dilemma. Full-thickness skin grafts (FTSGs) often result in an unsightly contour defect. Local flap options exist, but they frequently violate subunit boundaries or anatomical landmarks. In particular, the single-stage nasolabial transposition flap is particularly prone to blunting of the nasofacial angle and fullness or pin-cushioning of the flap with concomitant loss of facial symmetry. METHOD: We present a consecutive case series of 21 patients with lesions at this site who underwent reconstruction with a combination of a subcutaneous flap from the adjacent cheek fat, which is then resurfaced with an overlying FTSG. RESULTS: A range of defects of dimensions up to 17 mm diameter were included in the series. There were no instances of haematoma, post-operative infection or graft failure. A single patient, who smoked 30 cigarettes daily, underwent a complex reconstruction combining a cartilage graft with a fat flap and a skin graft. He experienced some epidermal loss that healed without intervention, with a remarkable outcome. The results show this to be a reliable and reproducible method that delivers excellent restoration of the contour without disrupting the symmetry of the nasofacial sulcus. CONCLUSION: Augmenting a skin graft with a subcutaneous fat transposition flap is a simple technique that is quick to learn and straightforward to execute. Excellent outcomes were consistently obtained without the asymmetry and pin-cushioning often associated with local flaps at this site.
    [Abstract] [Full Text] [Related] [New Search]