Reliability of the melolabial flap for alar reconstruction.

OBJECTIVE To review a series of alar reconstruction cases in which the melolabial flap was used. DESIGN Case series. SETTING University medical center and private practice. PATIENTS One hundred five consecutive patients with alar defects, resulting from oncologic resection, in whom melolabial flap reconstruction was suitable. INTERVENTION Single-stage melolabial flap reconstruction by a single surgeon (W.H.L.). MAIN OUTCOME MEASURE Viability of the flap and presence or absence of surgical complications. RESULTS There were no complete flap failures. Seven patients had partial necrosis of the distal end of the flap, and 3 of these instances occurred when the flap was rolled back onto itself to reconstruct the nasal vestibule; however, none of the patients required a subsequent operation or notching. Three patients developed hematoma, and 2 of them required a return to the operating room for control of bleeding. Four patients developed superficial infection, and 1 developed cellulitis of the cheek requiring opening of the wound and later revision of the flap. This was the only flap requiring revision. Fifteen patients required 3 or fewer corticosteroid infiltrations postoperatively for flap pin-cushioning or scar hypertrophy. CONCLUSION The melolabial flap is a reliable tool in the reconstructive armamentarium of the facial plastic surgeon.