Cutaneous Reconstruction of the Nasal Distal Third: Alternative Local Flaps for a Complex Region

Area of Science:

• Plastic Surgery
• Dermatologic Surgery
• Head and Neck Surgery

Background:

• Reconstruction of distal nasal cutaneous defects presents unique challenges due to rigid, sebaceous skin.
• Standard techniques may lead to unfavorable tension vectors, causing nasal free margin distortion.
• Effective reconstruction requires careful consideration of tension and cosmetic outcomes.

Purpose of the Study:

• To present and evaluate three alternative reconstructive techniques for distal nasal defects.
• To compare these methods with commonly used options for nasal reconstruction.
• To provide guidance on indications, surgical technique, and limitations of each flap.

Main Methods:

• Review and detailed discussion of the East-West flap, nasalis sling flap, and trilobed flap.
• Analysis of surgical techniques, indications, and limitations for each method.
• Comparative assessment against established reconstructive approaches for distal nasal defects.

Main Results:

• East-West, nasalis sling, and trilobed flaps offer versatile solutions for distal nasal reconstruction.
• These techniques can achieve excellent cosmetic results while managing tension effectively.
• Each flap presents specific advantages and limitations relevant to defect size and location.

Conclusions:

• The East-West, nasalis sling, and trilobed flaps are valuable alternatives for reconstructing distal nasal cutaneous defects.
• These methods provide surgeons with options to optimize functional and aesthetic outcomes.
• Careful patient selection and technique application are crucial for successful nasal reconstruction.