Bilateral Cheek Island Skin Flaps
The procedure described shows an excellent reconstruction of the columella. Location of the discrete artery may be very difficult; however, this procedure should be successful even if subcutaneous pedicles are used as an alternative source of blood supply.
Many procedures for reconstruction of the columella have been described, but we have found that bilateral cheek island skin flaps have provided gratifying results (1).
These flaps are useful in patients in whom the columella alone is missing or in whom there is also a concomitant defect of the upper lip.
FIGURE 73.1 A: Absence of the nasal columella. B: Bilateral island skin flaps are based on the anterior facial artery, which can be localized with a Doppler probe. C: The island flaps are tunneled through the upper lip and sutured together to form the columella. D: The flap donor-site wounds are closed by suturing the wound edges. (From Kaplan, ref. 1, with permission.)
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