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The subcutaneous melolabial island flap for nasal alar reconstruction: A clinical review with nuances in technique
Author(s) -
Arden Richard L.,
Miguel George S.
Publication year - 2012
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.23377
Subject(s) - medicine , surgery , debulking , nose , soft tissue , ovarian cancer , cancer
Objectives/Hypothesis: To describe our experience with surgical reconstruction of whole subunit nasal alar skin losses following Mohs ablative surgery, using a subcutaneous melolabial island flap with emphasis on a simplified technique to minimize facial scarring and optimize facial contour. Study Design: Retrospective review of case series. Methods: A single surgeon's results in 48 consecutive patients spanning 7 years were analyzed by comprehensive chart review. Details of wound site and flap‐specific complications were noted. Favorable nuances in surgical technique differing from standard approaches are graphically described. Results: Loss of melolabial sulcal depth was the most commonly seen donor‐site complication (8%). No cases of flap compromise were seen. An unexpectedly high frequency of subjective nasal obstruction was seen (37%) after the second stage, more common when cartilage grafts were underutilized, and with through‐and‐through defects at inception. External contour was uniformly good to excellent. Conclusions: The described variation in subcutaneous melolabial island flap transfer provides reliable soft tissue replacement for whole subunit alar skin losses with favorable donor‐site scarring and resultant contour. Attention to proper utilization of supportive cartilage grafts and ancillary debulking procedures is often necessary to optimize functional outcomes. Laryngoscope, 2012