Subcutaneous pedicle flap reconstruction of lower nasal defects

Abstract

Large defects of the thick, immobile lower nasal skin are most optimally reconstructed by use of the single stage, reliable and cosmetically acceptable subcutaneous pedicle flap. Skin incisions are minimized and are easily placed in natural skin lines. The donor defect is closed directly. Grafts, other local flaps or regional flaps present the disadvantages of less ideal color or contour match, reduced flap mobility, restricted available skin, additional or more obvious donor site scarring or distortion, or unnecessary complexity.

Prefabricated Nasolabial Flap for Reconstruction of Full-Thickness Distal Nasal Defects

“…Hoping to achieve a more mobile flap, many authors have used subcutaneously based nasolabial flaps 7,14,16,18,33,41–46 . In the case of a subcutaneously based flap, the dermal vascular plexus is disrupted, and the viability of the flap relies solely on the subcutaneous vessels 47 .…”

Prefabricated Nasolabial Flap for Reconstruction of Full-Thickness Distal Nasal Defects

“…[2][3][4][5][6][7][9][10][11]13,15,18,24,26,27,33,36,41,42 Hoping to achieve a more mobile flap, many authors have used subcutaneously based nasolabial flaps. 7,14,16,18,33,[41][42][43][44][45][46] In the case of a subcutaneously based flap, the dermal vascular plexus is disrupted, and the viability of the flap relies solely on the subcutaneous vessels. 47 Fosko and Dzubow suggested that superior subcutaneously based nasolabial flap is a random pattern flap, supplied by the musculocutaneous perforator branches of the superior labial artery and transverse facial artery.…”

Aesthetic Refinement of the Dog Ear Correction: The 90° Incision Technique and Review of the Literature

“…Despite good preoperative planning for skin management techniques including Burow's triangle, V-Y advancement flap, M-plasty [3], and S-plasty [4], and despite following intraoperative procedures including proper undermining of a shallow wound, proper 90° angle of the scalpel blade, precise suture placement, and removal of excess underlying fat, sometimes a dog ear occurs anyhow. Methods for correcting dog ears include excision of the excess tissue in the shape of a triangle, crescent or ellipse; excision of conical folds of tissue at the end of the wound in the same direction as the long axis of the original wound; and excision of the dog ear at a 120° angle to the long axis of the existing excision line in a shape resembling a hockey stick [5]. They are extensively described in the literature, but they all lead to wound extension.…”