Nasal Plus Nasolabial Skin Flaps for Reconstruction of The Nasal Dorsum
J. W. SNOW
Procedure should be considered as a second option, if the forehead flap is not available.
The use of an L-shaped skin flap with its base straddling the midline at the root of the nose and its distal aspect overlying the lateral aspect of the nasal pyramid has been found effective for reconstruction of the caudal half of the nasal dorsum following tumor excision. The donor site is closed with an L-shaped nasolabial skin flap.
Both these flaps have good vascularity, as well as the proper skin color match and thickness. The lines of inset fall within the natural lines of the nose and nasolabial region. This technique is different from a bilobed flap, which shares a mutual base (see Chapter 35).
The underlying cartilage and bone may be planed if a hump is present in order to decrease the length of the basic flap; i.e., the shortest distance between two points is a straight line. Removal of part of the cartilage and bone may be done with impunity.