[Upper nasolabial flap: improving the surgical technique].

Area of Science:

• Plastic Surgery
• Dermatologic Surgery
• Reconstructive Surgery

Background:

• The upper nasolabial flap, described by Kilner and popularized by Préaux, is a recognized technique for nasal ala reconstruction.
• Conventional methods can result in noticeable scars and lack a distinct nostril groove.
• Improvements are sought to enhance the cosmetic and functional results of nasal reconstruction.

Observation:

• A modified upper nasolabial flap technique was applied to an 82-year-old female patient with basal cell carcinoma on the right nasal wing.
• Key modifications involved dissecting the superior skin triangle forward and removing the flap pedicle epidermis.
• The flap was advanced to reconstruct the alar defect, creating a nostril groove and a single, more discreet scar.

Findings:

• The modified technique successfully reconstructed the alar defect, recreating a nostril groove.
• The resulting scar was more discreet compared to the conventional upper nasolabial flap.
• The patient experienced an uneventful postoperative course.

Implications:

• This modified technique offers a simple, reliable, and aesthetically elegant solution for nasal ala reconstruction.
• It enhances the cosmetic outcome of nasal reconstruction while retaining the advantages of the original flap.
• The technique provides an improved option for patients requiring reconstruction of alar defects, particularly those with skin cancer.