Reconstruction of small to medium defects in the soft tissues of the nose with nasalis musculocutaneous V-Y advancement flaps

Abstract

Defects in the soft tissues of the nose are usually reconstructed with skin grafts or frontal flaps. However, skin grafts may cause scar tissue and changes in colour. Frontal flaps, however, may be thicker than normal skin and may give unsatisfactory results. Nasalis musculocutaneous V-Y advancement flaps avoid these disadvantages. We suggest an algorithmic approach for the use of these flaps in the reconstruction of small to medium defects in the soft tissues of various regions of the nose. The pedicles of these flaps are the dorsal and lateral nasal arteries. This approach provides a simple, safe, and reliable reconstruction for small and medium defects in the soft tissues of the nose.

An “oxhorn”-shaped V–Y advancement flap unilaterally pedicled on a nasal superficial musculoaponeurotic system for nasal reconstruction

“…7 All of the main vessels, including the lateral nasal artery, dorsal nasal artery, terminal branches of the anterior ethmoid artery and nasal columella branch of the superior labial artery, run in the nasal SMAS and supply the nasal skin by branching to penetrate the nasal SMAS and anastomose ( Figure 2A). 8,9 The abundant anastomosis ensures that there liable blood supply of the nasal skin is preserved, regardless of the direction from which the vessels come. In the present literature, the laterally and inferiorly based pedicle has been described in detail, but reports regarding the superior pedicle were rare.…”

Nasolabial interpolation flap for nasal alar reconstruction after skin tumor resection

“…Two other important aspects are also recommended: replacement skin should be similar to the original skin thickness, size, color, and texture and restoration of its intricate tridimensional structure 7,8 . Ideally, surgery restores the aesthetic appearance, so nasal imperfections are not noticed at a normal conversational distance.…”