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The Wave Flap: A Single-Stage, Modified Nasal Sidewall Rotation Flap for the Repair of Defects Involving the Mid-Alar
Zachary T Bryan1, Algin B Garrett, Kerry Lavigne
1*Department of Dermatology, Saint Louis University School of Medicine, St. Louis, Missouri; †Department of Dermatology, Virginia Commonwealth University, Richmond, Virginia; ‡Department of Radiology, Eastern Virginia Medical School, Norfolk, Virginia; §Department of Dermatology, Saint Louis University, St. Louis, Missouri.
Background:
Reconstruction of defects straddling the alar groove presents the dual challenges of resurfacing the nasal sidewall and alar subunits while simultaneously recreating the alar groove. The wave flap (WF) is a modified, medially based, nasal sidewall rotation flap that uses locally recruited tissue from the nasal sidewall to facilitate color and texture match and permit camouflage of scars.
Objective:
To detail a surgical repair for defects in the horizontally oriented middle third of the alar groove.
Materials And Methods:
This retrospective case series describes a technique for repair of defects involving the alar groove. Using postoperative photographs, outcomes were assessed by blinded noninvestigator dermatologist raters using the Observer Scar Assessment Scale.
Results:
Between February 2012 and June 2013, 10 patients were reconstructed using a WF design. Subjective assessment of scar vascularity, pigment, pliability, relief, and thickness by 3 independent reviewers yielded an overall cosmesis score of 11.1 (out of 50). No complications were noted.
Conclusion:
The WF provides an excellent reconstructive option for Mohs defects of the middle third of the alar groove by recruiting local tissue and permitting maximum scar camouflage. A well-designed and executed WF provides cosmetically exceptional results for defects of the alar groove.
