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Nasolabial Flap Variations and Alternatives in Nasal Ala Reconstruction
Julian R Andresen1, Oliver Scheufler2
1From the Department of Orthopaedics and Trauma Surgery, Division of Trauma Surgery, Medical University of Vienna.
Plastic and Reconstructive Surgery
|August 28, 2025
Summary
Single-stage nasolabial flaps offer good aesthetic outcomes for alar reconstruction. However, frequent unplanned secondary surgeries are a concern with this technique.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Otolaryngology
Background:
- Nasolabial flap variations exist for alar reconstruction, but optimal selection remains unclear.
- This study analyzes the performance of different nasolabial flap variations.
Purpose of the Study:
- To compare the effectiveness of single-stage and two-stage nasolabial flaps for alar reconstruction.
- To evaluate outcomes of nasolabial flaps against alternative reconstructive methods.
Main Methods:
- Retrospective review of 148 alar reconstructions over 10 years (2012-2022).
- Analysis of defect size, reconstructive technique, cartilage grafts, complications, and secondary procedures.
- Clinical follow-up at 3, 6, and 12 months with photographic evaluation of aesthetic outcomes.
Main Results:
- 110 of 148 reconstructions used nasolabial flaps (90 single-stage, 20 two-stage).
- Complications occurred in 29% of patients; unplanned secondary surgery was frequent (44%) in single-stage nasolabial flaps.
- Single-stage nasolabial flaps demonstrated favorable aesthetic results compared to other techniques.
Conclusions:
- Single-stage nasolabial flaps provide aesthetically pleasing results for alar reconstruction.
- Despite good aesthetics, a high rate of unplanned secondary procedures necessitates careful consideration.
- Nasolabial flaps, particularly single-stage variations, are a viable option for alar reconstruction.
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