Arch Plast Surg.  2018 May;45(3):253-258. 10.5999/aps.2017.00878.

Delayed bipedicled nasolabial flap in facial reconstruction

• Goh CS
• Perrett JG
• Wong M
• Tan BK

• KMID: 2413021
• DOI: http://doi.org/10.5999/aps.2017.00878

Abstract

BACKGROUND
The nasolabial flap is ideal for reconstruction of the nasal alar subunit due to its proximity, color and contour match, and well-placed donor scar. When raised as a random-pattern flap, there is a risk of vascular compromise to the tip with increased flap length and aggressive flap thinning. Surgical delay can greatly improve the chances of tip survival, allowing the harvest of longer flaps with greater reach.
METHODS
We describe our technique of lengthening the nasolabial flap through multiple delay procedures. A bipedicled flap was first raised and then transferred as a unipedicled flap with a 6:1 length-to-width ratio. During the delay process, the flap tip was thinned to the subdermal layer.
RESULTS
In our case series of seven patients, defects as far as the medial canthal area and contralateral ala were reconstructed successfully with no incidence of tip necrosis or flap loss. The resultant flaps were thin enough to be folded over for the reconstruction of alar rim defects.
CONCLUSIONS
We highlight the success of our surgical technique in creating thin and robust nasolabial flaps for the reconstruction of full-thickness defects around the nose.

Keyword

Reconstructive surgical procedures; Surgical flaps; Nasolabial fold; Graft survival

MeSH Terms

Cicatrix
Graft Survival
Humans
Incidence
Nasolabial Fold
Necrosis
Nose
Reconstructive Surgical Procedures
Surgical Flaps
Tissue Donors