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Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction
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The Bilobe Flap for Nasal Reconstruction.

Tyler S Okland1, Yu Jin Lee1, Akshay Sanan1

  • 1Division of Facial Plastic and Reconstructive Surgery, Stanford University, Palo Alto, California.

Facial Plastic Surgery : FPS
|June 9, 2020
PubMed
Summary

The bilobe flap effectively repairs nasal defects, with careful thinning minimizing pincushioning and improving aesthetic outcomes. This technique reduces revision rates for nasal reconstruction.

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Area of Science:

  • Plastic Surgery
  • Reconstructive Surgery
  • Facial Plastic Surgery

Background:

  • Nasal defect repair is challenging due to inelastic skin and complex geometry.
  • The bilobe flap offers a solution for lower nose defects but can cause pincushioning.
  • Minimizing aesthetic complications is crucial for patient satisfaction.

Purpose of the Study:

  • To review a single surgeon's experience with bilobe flap reconstruction for nasal defects.
  • To describe a surgical technique aimed at minimizing pincushioning and poor aesthetic outcomes.
  • To analyze complication and revision rates associated with the bilobe flap.

Main Methods:

  • Retrospective chart review of 125 patients undergoing bilobe flap reconstruction.
  • Analysis of postoperative clinic notes for complications and cosmetic outcomes.
  • Detailed description of the surgical technique, including flap thinning.

Main Results:

  • 16% of patients experienced complications; 4% required revision surgery.
  • Pincushioning occurred in 3.2% of patients, with most successfully managed by scar revision.
  • No significant association found between cartilage grafts or defect size and complications.

Conclusions:

  • The bilobe flap is a valuable technique for small nasal tip defects.
  • Adequate thinning of the flap minimizes pincushioning and enhances aesthetic results.
  • This technique improves outcomes and reduces the need for revision surgery.