Bilobed flaps for cutaneous nasal defects: a case series

Abstract

The bilobed flap is a local flap used for the reconstruction of small to moderate cutaneous nasal defects. It was first described by Esser in 1918 for use in nasal tip reconstruction. It is a double transposition flap where the first flap serves to fill the primary defect, and a second smaller fills the secondary defect. This approach seeks to distribute tension across a wider area. It is a random pattern flap with no specified blood supply. This study was done at the department of plastic and reconstructive surgery, Saveetha medical college and hospital, from January 2018 to December 2018. Five patients (four female and one male) underwent bilobed flap to reconstruct the cutaneous nasal defects out of which three patients had naevus while two patients had basal cell carcinoma nose. Their ages ranged from 35-68 years with a mean age of 52 years. The procedures were done under local anaesthesia. Post-operatively, all sutures were removed on the 5th day. This technique was performed in 5 cases with defect size ranging from 0.9×1.1 to 1.3×1.8 cm. All defects were closed under minimal wound tension, all scars were inconspicuous, no obvious complications occurred, and the aesthetic outcomes were considered favorable. The bilobed flap is a versatile, easy to perform and reliable flap for closure of small nasal cutaneous defects with good aesthetic outcomes, reduced morbidity and less scarring.