OBJECTIVE To determine whether differences of angles between the alar rim and the long axis of the secondary defect in a Zitelli bilobed flap affect alar displacement in a fresh cadaver model. METHODS In fresh cadaver heads, identical, unilateral 1-cm circular defects were created at the superior alar margin. Three different laterally based bilobed flap templates for reconstruction were used....

OBJECTIVE Reconstruction of alar structures of the nose remains difficult. The result has to be not only functional but also aesthetic. Different solutions to reconstruct alar defects are feasible. A good result that meets the specific demands on stability, aesthetics, and stable architecture without shrinkage of the area is not easily achieved. METHOD A perichondrial cutaneous graft (PCCG), ...

Cephalic malposition of lower lateral cartilage (CMLLC) is one of the most common objects of aesthetic and functional rhinoplasty. Constantian wrote in his article that 68% of his primary rhinoplasty cases had lateral crural malpositioning.1 To diagnose CMLLC the surgeon has to observe several parameters that were described by Sheen: malposition is “any displacement of the lateral crura from th...

BACKGROUND The site, size, and depth of tissue loss, irradiation, or composite injury to adjacent cheek and lip may make local tissues inadequate or unavailable for the repair of major nasal defects. METHODS In 13 patients, a single, folded, horizontal radial forearm flap was used to line the vault and columella, with an incontinuity fasciocutaneous extension to resurface the nasal floor, wit...

Cutaneous tumors located on the nasal ala often pose challenges to a Mohs surgeon because of the ala’s unique anatomy. Hemostasis is difficult and, if not accomplished quickly and fully, leads to an obscured surgical field. Intraoperative trauma can result in both patient and surgeon due to frequent blotting and blood clearing attempts in a small anatomic area. The usual method of pressure appl...

OBJECTIVES To review the repair of smaller nasal defects (≤1.5 cm) and their associated complications, elaborating on nasal obstruction and techniques to avoid it, and to determine outcomes with functional cartilage grafting. METHODS The medical records of patients requiring nasal reconstruction for Mohs defects 1.5 cm or smaller were reviewed. Variables analyzed included defect location, def...

In 2009, we have described the use of freestyle facial artery perforator flaps for one-stage nose reconstruction. Since then, several articles have reported the use of facial artery perforator flaps for nose reconstruction. The purpose of this article is to provide an update of the published technique after 10 years of experience. Since 2004, 21 patients have been treated with a freestyle facia...