Repair of nasal tip and alar defects using cheek-based 2-stage flaps: an alternative to the median forehead flap.

OBJECTIVE To describe our use of cheek-based 2-stage transposition flaps for repairing Mohs surgery defects of the lower third of the nose. DESIGN Retrospective case series. SETTING Private dermatologic day surgery facility. Patients Twenty-eight patients with defects of the lower third of the nose after Mohs surgery. Intervention Ten alar and 18 nasal tip defects repaired using cheek-based 2-stage transposition flaps. MAIN OUTCOME MEASURES Acceptability of procedure to patient, complications, and appearance from photographic records. RESULTS The procedures were well tolerated and achieved good cosmetic results without major complications. CONCLUSIONS These flaps allow repair of extensive defects of the nasal tip and ala with the patient under local anesthesia. This approach provides an alternative to the median forehead flap for nasal tip repairs.