The mosaic flap for single-stage reconstruction of nasal ala defects

Postoperative Outcomes of Local Skin Flaps Used in Oncologic Reconstructive Surgery of the Nasal Ala: A Systematic Review

“…Additionally, Riml's reported mosaic flap, a double transposition flap, uses neighboring tissue reserve to optimize match, conceal the donor scar within the melolabial crease, and preserve the alar cheek junction, with only one complication of delayed wound healing in a patient with lymphoma. 22 Five uncontrolled studies on typical and atypical variations of rotations flaps were identified in our review. Rotation flaps on the ala demonstrated overall positive functional and cosmetic outcomes; local anatomical and design factors may help to explain this.…”

“…Additionally, Riml's reported mosaic flap, a double transposition flap, uses neighboring tissue reserve to optimize match, conceal the donor scar within the melolabial crease, and preserve the alar cheek junction, with only one complication of delayed wound healing in a patient with lymphoma. 22…”

“…18 Other typical and atypical variations of local transposition (bilobed, trilobed, and mosaic) flaps were also described in our review to produce favorable aesthetic results with minimal or no complications. [19][20][21][22] Despite these positive trends, the literature has cautioned against using bilobed flaps for alar reconstruction due to their limited reach and potential for alar notching and blunting of the groove. 23 Medially based, rather than laterally based, bilobed and trilobed flaps may be more beneficial for nasal ala defects to prevent the blunting of the nasal groove.…”