Aesthetic Repair of Small to Medium-Sized Nasal Defects

Shah, Anil R.; Zoumalan, Richard A.; Constantinides, Minas

doi:10.1055/s-2007-1021893

Cited by 11 publications

(15 citation statements)

References 33 publications

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“…The present study demonstrates that almost one-third of patients, who have local flaps inset into the nasal region, have all of the positive aesthetic parameters. Aesthetic parameters were better for local flaps than for full-thickness skin grafts, which is compatible with results of other authors 4,20,22,25 .…”

Section: Aesthetic Characteristicssupporting

confidence: 91%

“…Esthetic considerations, such as skin texture, color, and contour, used in the resurfacing of skin defects have been chronicled in the evolution of nasal reconstruction 21 . Skin color, texture and contour play a critical role in final determination of the reconstruction type 22 . Local flaps for the nasal skin coverage of defects evolved along the principle of "replacing like with like" in providing ideal skin color and texture match 23 .…”

Section: Aesthetic Characteristicsmentioning

confidence: 99%

“…Local flaps for the nasal skin coverage of defects evolved along the principle of "replacing like with like" in providing ideal skin color and texture match 23 . Local flaps typically offer better aesthetic results than fullthickness skin grafts 20,22,24 .…”

Section: Aesthetic Characteristicsmentioning

confidence: 99%

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Analysis of reconstructive methods in surgical treatment of nasal skin defects

Jović

Dimitrijević²,

Dimitrijević³

et al. 2016

VOJNOSANIT PREGL

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Section: Aesthetic Characteristicssupporting

confidence: 91%

Section: Aesthetic Characteristicsmentioning

confidence: 99%

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Analysis of reconstructive methods in surgical treatment of nasal skin defects

Jović

Dimitrijević²,

Dimitrijević³

et al. 2016

VOJNOSANIT PREGL

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“…A variety of local flaps, that is, rotation flaps, advancement flaps, island flaps, and bilobed flaps are described. [2][3][4][5] But even with these more challenging techniques-compared with a simple skin graft-the absence of asymmetries and warping are difficult to reach. The length of the scars, the widespread undermining and the postoperative long lasting or even persisting swelling are severe problems.…”

mentioning

confidence: 99%

Skin-Fat-Graft: A Simple Tool for Reconstruction of Small Deep Defects of the Nose

2014

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Small deep defects of the nose after resection of benign or malignant skin tumors are a common challenge in facial plastic surgery daily routine. The use of local flaps has several disadvantages for what reason they are a minor or no option especially in certain localizations in the lower third of the nose. Many elder patients suffer from comorbidities where complex more-staged reconstructional procedures drop out. We present a technique of nasal defect closure with a skin-fat composite graft. Between April 2010 and July 2013, we treated 42 patients with a total of 46 skin-fat-grafts to the nose. We reevaluated the esthetic and functional outcome in a retrospective analysis. In 80% of the cases, the results were rated excellent to satisfactory, 20% fair to poor. Reasons for worse validation were color and contour differences of grafts and surrounding tissue as well as alar retraction in very few cases. Nevertheless, we consider skin-fat-grafts to be a useful tool in single-layer nasal reconstruction in defects of smaller size.

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“…In particular, tip twisting and alar retraction are the feared complications of central tip repair with bilobe flap. 7,8 The senior author (S. P. M.) has previously described the double-half bilobe flap as an alternative to the standard bilobe flap for the reconstruction of midline nasal defects. 9,10 Nineteen patients underwent double half bilobe flap for repair of midline defects.…”

Section: Double Half Bilobe Flapmentioning

confidence: 99%

The Bilobe Flap for Nasal Reconstruction

et al. 2020

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Repair of nasal defects is technically challenging due to inelastic nasal skin and unforgiving nasal geometry. The bilobe flap is a double transposition flap that can transpose skin from cephalad to caudad to repair defects of the lower third of the nose. However, pincushioning may complicate this flap, yielding untoward aesthetic outcomes. We review our single surgeon series of patients who underwent bilobe flap reconstruction of nasal defects, and describe our surgical technique to minimize pincushioning and poor aesthetic outcomes. This was a retrospective chart review of patients who underwent bilobe flap reconstruction of nasal defects at a tertiary referral facial plastic and reconstructive surgery clinic between January 1, 2010 and February 12, 2019. All postoperative clinic notes were analyzed for complications, reports of unfavorable cosmetic outcome, and rates of revision procedures. Surgical technique is described. In the analysis, 125 patients were included, of whom 84 (67%) patients were women, and the mean (standard deviation) age was 60.7 (12.5) years. Complications were reported in 20 (16%) patients, including scars, pincushioning, and nasal obstruction. Five patients underwent revision surgery (4%), including scar revision and z-plasty. Pincushioning was reported in four patients (3.2%), of whom three underwent scar revision procedures. One patient had alar notching requiring correction. There was no statistically significant association between ear cartilage graft and complications (p = 0.84) or requirement of intervention (p = 1.0). Univariate and multivariate logistic regression did not show statistically significant association between size of the defect and the presence of complications (p > 0.05). The bilobe flap is an excellent transposition flap for the repair of small nasal tip defects. By adequately thinning the transposition flap of excess subcutaneous tissue prior to inset, rates of poor aesthetic outcomes, revision procedures, and pincushioning are minimized.

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Aesthetic Repair of Small to Medium-Sized Nasal Defects

Cited by 11 publications

References 33 publications

Analysis of reconstructive methods in surgical treatment of nasal skin defects

Analysis of reconstructive methods in surgical treatment of nasal skin defects

Skin-Fat-Graft: A Simple Tool for Reconstruction of Small Deep Defects of the Nose

The Bilobe Flap for Nasal Reconstruction

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