[Nasal reconstruction using the Converse frontal flap or a Washio retroauricular flap. Technical notes]

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Facial Anatomy

Background:

• Nasal reconstruction presents challenges in achieving optimal aesthetic and functional outcomes.
• The Converse Scalping Flap and Washio Temporo-auricular flap are established techniques for nasal reconstruction.

Purpose of the Study:

• To evaluate and refine the application of the Converse Scalping Flap and Washio Temporo-auricular flap in nasal reconstruction.
• To identify critical details for ensuring high-quality results in nasal reconstruction using these flap techniques.

Main Methods:

• Retrospective analysis of 14 cases of nasal reconstruction over three years.
• Detailed examination of flap characteristics, including material requirements and pedicle weaning protocols.
• Specific anatomical landmarks and incision lines for the Washio flap were defined and analyzed.

Main Results:

• The Converse Flap requires no bone or cartilage reinforcement for reconstructions of the inferior two-thirds of the nose when adequately thinned.
• A pedicle weaning method allows scalp replacement on the 13th day post-surgery.
• The Washio flap should utilize mastoidian skin, and its back-cut follows a specific geometric line (AC line) defined by three points (A, B, C).

Conclusions:

• The Converse Scalping Flap is a reliable and effective technique for medio-facial reconstructions, particularly for the lower nose.
• The refined Washio technique demonstrates improved fiability but does not surpass the Converse flap's efficacy.
• Attention to flap thickness and specific anatomical guidelines enhances surgical outcomes in nasal reconstruction.