Two Adjacent Capillary Perforator Flaps? A Reconstruction of a Full-thickness Alar Defect

Area of Science:

• Plastic Surgery
• Dermatologic Surgery
• Reconstructive Surgery

Background:

• Nasal reconstruction presents significant challenges for plastic surgeons.
• Skin tumors often occur in older patients with available skin for local flaps.
• Local flaps allow for 'like with like' reconstruction of excised nasal defects.

Purpose of the Study:

• To present a case of successful nasal reconstruction for malignant melanoma.
• To demonstrate the use of two adjacent local capillary perforator flaps for alar and lateral nasal defects.
• To highlight a novel combination of flaps for single-stage reconstruction.

Main Methods:

• A full-thickness alar and partial lateral nasal defect due to malignant melanoma was addressed.
• Two adjacent local capillary perforator flaps were utilized: one for inner lining, one for outer lining.
• A minor touch-up procedure was performed after 3 months for improved cosmetic outcome.

Main Results:

• Successful single-operation reconstruction of a full-thickness alar defect was achieved.
• The combined use of two adjacent capillary perforator flaps provided both inner lining and outer coverage.
• Post-correction results demonstrated improved cosmesis, supported by video evidence.

Conclusions:

• This case demonstrates the successful application of a combined adjacent capillary perforator flap technique for nasal reconstruction.
• This method offers an effective solution for full-thickness alar defects, particularly those resulting from malignant tumor excision.
• This represents the first reported instance of this specific flap combination for nasal reconstruction, documented with a video demonstration.