Dermatochirurgie – Tricks of the Trade / Dermatosurgery – Tricks of the Trade
A folded locoregional flap is a good alternative for reconstruction of a full-thickness alar defect and has an excellent blood supply that makes it suitable for reconstructive surgery.
Abstract
The nose has a complex three-dimensional structure and plays a crucial role in breathing, olfaction, and phonation. Reconstructive surgery in this area should be chosen according to its purpose and the entity of the defect.1 Full-thickness defects of the nasal ala should be repaired providing both aesthetic and functional results (to restore symmetry of the nose and to maintain patent airway inlet). For this purpose, a wide variety of reconstructive options have been described, ranging from skin graft (with or without a free auricular cartilage graft) to locoregional flap.2 Generally, locoregional flap provides a much better aesthetic result than skin grafting. Furthermore, the survival of a composite graft is dependent on multiple factors.3 An auricular cartilage graft is often used in addition to prevent collapse of the nasal mucosa; however, as reported by van der Eerden et al, it gives unsatisfactory aesthetic results in 23%of cases andhas a risk of infection (chondritis) and discoloration.4 Therefore, a folded locoregional flap is a good alternative for reconstruction of a full-thickness alar defect. Thenasolabial flap is thepreferred locoregional flapused; it has an excellent blood supply that makes it suitable for