Nasal tip reconstruction: the horizontal "J" rotation flap using skin from the lower lateral bridge and cheek

The horizontal "J" flap is a rotation flap that uses skin from the lower lateral bridge and cheek to repair full-thickness skin defects of the nasal tip. Pertinent anatomic morphologic characteristics of the nasal tip skin that contribute to the unique character of the nose are discussed. The example defects presented resulted from the excision of skin cancers using micrographic surgery. Nasal tip reconstruction, using adjacent skin based on the nasal anatomic subunit principle, results in superior aesthetic repairs.