The Rintala Advanced Modification (RAM) Flap: A Novel Technique for Off-Centre Nasal Reconstruction

Area of Science:

• Plastic Surgery
• Dermatologic Surgery
• Reconstructive Surgery

Background:

• The traditional Rintala flap for nasal reconstruction can result in noticeable forehead scarring and glabellar deformities.
• Existing reconstructive techniques may not fully address aesthetic concerns in the glabellar region.
• Minimizing visible scarring and achieving natural-looking results are key goals in nasal reconstruction.

Purpose of the Study:

• To introduce and evaluate the Rintala Advanced Modification (RAM) flap as a novel technique for nasal reconstruction.
• To assess the aesthetic outcomes and complication rates associated with the RAM flap.
• To compare the RAM flap's results against the limitations of the traditional Rintala flap.

Main Methods:

• Description of the Rintala Advanced Modification (RAM) flap technique, including its placement below the eyebrow line.
• Utilization of asymmetric Burow's triangles to manage off-centre nasal defects.
• Application of the RAM flap in a cohort of 20 patients undergoing reconstruction for nasal basal cell and squamous cell carcinomas.

Main Results:

• The RAM flap demonstrated superior aesthetic outcomes in the studied patient group.
• No instances of glabellar complications were reported following reconstruction with the RAM flap.
• The technique successfully avoided flap tip necrosis, indicating its reliability.

Conclusions:

• The Rintala Advanced Modification (RAM) flap offers a significant improvement over the traditional Rintala flap for nasal reconstruction.
• The RAM flap effectively minimizes forehead scarring and prevents glabellar deformities, enhancing patient aesthetics.
• This modified technique provides a safe and effective option for reconstructing nasal defects, particularly those resulting from skin cancer excision.