Technique for Reconstruction of Nasal Alar Defects in Asian Patients with a Modified Bilobed Nasolabial Flap

Technique for Reconstruction of Nasal Alar Defects in Asian Patients with a Modified Bilobed Nasolabial Flap

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Corresponding Author
Priya Tiwari
Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore

A B S T R A C T

Introduction: The Oriental nose differs from the Caucasian nose in terms of size, subunit definition, texture, and thickness of the skin [1]. Zitelli’s bilobed flap enables aesthetic reconstruction in Caucasian noses but in smaller Oriental noses the outcomes are less desirable with nasal alar retraction commonly seen [2]. Hence, we describe a modification of Zitelli’s bilobed flap incorporating nasolabial skin for a single stage nasal reconstruction with reduced nasal alar retraction [3]. Methods: We modified the bilobed flap based on Zitelli’s bilobed flap and the aesthetic subunit principle, as modified for Orientals by Yotsuyanagi in 2000 [4]. The primary lobe was located between the defect and the cheek and the second lobe was located on the cheek, above the nasolabial fold. The modification of the bilobed flap was designed to have a primary lobe that was 10% longer than the length of the distal defect edge from the flap’s pivot point, and the width of the primary lobe was equal to the width of the defect. The length of the secondary lobe was 130% of the length of the distal defect edge to the flap’s pivot point, and the width of the secondary lobe was two-thirds the width of the primary lobe. Results: Satisfactory alar reconstruction was achieved from the viewpoint of the patient and surgeon. There was good nasal contour and appropriate symmetry of the nasal tip with reduced nasal alar retraction. Conclusion: The modification of Zitelli’s bilobed flap to have a longer primary lobe and include nasolabial skin, results in reduced nasal alar retraction.

Article Info

Article Type
Case Report
Publication history
Received: Mon 07, Dec 2020
Accepted: Thu 17, Dec 2020
Published: Fri 01, Jan 2021
Copyright
© 2021 Priya Tiwari. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository. All rights reserved.
DOI: 10.31487/j.SCR.2021.01.01