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

Bilobed transposition flaps are versatile random pattern flaps used in nasal and extranasal reconstruction as they preserve free margins, access distal tissue reservoirs, and reliably repair dynamic defects.

We highlight the utility of extranasal bilobed flaps to encourage surgeons to consider these flaps for Mohs micrographic surgery defects.

A two-institution retrospective chart review of patients reconstructed using an extranasal bilobed flap after Mohs micrographic surgery was performed. A validated scar scale was applied to postoperative photographs. Statistical analyses of the patient and surgery characteristics including patient co-morbidities, anatomic distribution, flap dimensions, and postprocedural events, including revisions, were conducted.

Forty-eight patients were identified. Site-specific flap dimensions were obtained with the cheek/lower eyelid requiring greater tissue mobilization with a higher final to primary defect ratio when compared with other sites. Postoperative events (complications, erythema, flap fullness, dehiscence, infection, etc.) were minimal. No major complications were noted. Nine cases of flap fullness or swelling were identified. Neither flap fullness nor dehiscence compromised flap integrity or cosmetic outcome. Independent flap cosmetic outcome review was good using a validated photographic scar scale.

Bilobed transposition flaps are versatile repairs for extranasal reconstruction with a favorable safety and outcome profile.