Use of Extranasal Bilobed Transposition Flaps in Cutaneous Reconstructive Surgery at 2 Institutions.

Area of Science:

• Plastic Surgery
• Dermatologic Surgery

Background:

• Bilobed transposition flaps are versatile random pattern flaps for nasal and extranasal reconstruction.
• They preserve free margins, access distal tissue, and repair dynamic defects effectively.

Purpose of the Study:

• To highlight the utility of extranasal bilobed flaps for defects resulting from Mohs micrographic surgery.
• To encourage surgeons to consider these flaps in their reconstructive armamentarium.

Main Methods:

• A retrospective chart review of 48 patients undergoing extranasal bilobed flap reconstruction after Mohs surgery across two institutions.
• Analysis of patient and surgical characteristics, including flap dimensions and post-procedural events.
• Application of a validated scar scale to postoperative photographs for cosmetic outcome assessment.

Main Results:

• Cheek/lower eyelid defects required greater tissue mobilization and a higher flap-to-defect ratio.
• Postoperative complications were minimal, with no major adverse events.
• Flap fullness/swelling occurred in nine cases but did not compromise flap integrity or cosmetic results, which were rated as good.

Conclusions:

• Extranasal bilobed transposition flaps are a safe and effective reconstructive option for extranasal defects.
• These flaps demonstrate a favorable safety and outcome profile for post-Mohs surgery reconstruction.