Single-Stage Total Alar Reconstruction Using an Integrated Lining Nasolabial Flap.

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Otolaryngology

Background:

• Total alar reconstruction presents challenges due to complex anatomy and dynamic requirements.
• Conventional methods often involve multiple stages, additional donor sites, and variable long-term stability.
• The Integrated Lining Nasolabial Flap is introduced as a novel single-stage technique.

Purpose of the Study:

• To evaluate the functional and aesthetic outcomes of the Integrated Lining Nasolabial Flap for total alar reconstruction.
• To assess postoperative alar stability, particularly the role of nasal dilator use.
• To determine if this technique can eliminate donor-site morbidity and the need for secondary procedures.

Main Methods:

• Retrospective review of 20 patients undergoing single-stage total alar reconstruction with the Integrated Lining Nasolabial Flap.
• Analysis included patients with at least 6 months of follow-up, recording complications and alar stability.
• Cosmetic outcomes were assessed using visual analog scale (VAS) and FACE-Q, correlated with nasal dilator compliance and patient age.

Main Results:

• No flap loss or major complications were observed in 20 patients (median follow-up 12.5 months).
• Late complications included alar retraction and asymmetry in 40% of patients.
• Alar collapse occurred in 15% of patients, exclusively among those noncompliant with nasal dilator use (P = 0.004).

Conclusions:

• The Integrated Lining Nasolabial Flap provides a single-stage solution for total alar reconstruction, integrating the lining and avoiding extra donor sites.
• Sustained postoperative nasal dilator use is significantly associated with improved alar stability.
• This technique potentially reduces surgical complexity and donor-site morbidity.