Bilobed Nasal Skin Flaps

Bilobed Nasal Skin Flaps



The bilobed nasal flap is a useful and time-honored technique for reconstructing defects of the nose and various other regions of the body (1, 2, 3, 4). It is a transposition flap consisting of two lobes of skin and subcutaneous tissue based on a common pedicle (5).


This flap is essentially a rotation flap divided into two transposition flaps. The bilobed flap has a random-pattern blood supply. However, there is evidence that, when the flap is designed near the level of the inner canthus, a portion has a direct axial blood supply (angular and supraorbital arteries) (8). The flap is composed of full-thickness nasal skin and subcutaneous tissue. A readily apparent cleavage plane is established between the flap and the underlying muscular elements.


Approaches to the bilobed flap have changed over time from consideration of two flaps alike in size and form to the utilization of a smaller secondary flap, more triangular in shape, facilitating closure of the donor deformity (9). Esser (10), the first to describe the use of bilobed rotation flaps for the repair of nasal tip defects, believed that 90° was the optimal angle between the two flaps; however, it could vary between 95° and 180° (11). The greater the angle, the larger is the resultant dog-ear that must be adjusted. This should be considered when planning the flap, because trimming the excess tissue can compromise the vascular pedicle.

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Jun 26, 2016 | Posted by in General Surgery | Comments Off on Bilobed Nasal Skin Flaps
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