The versatile menu of the nasolabial flap in nasal reconstruction: A defect-based algorithm

Area of Science:

• Plastic and Reconstructive Surgery
• Facial Reconstruction
• Nasal Subunit Reconstruction

Background:

• The nasolabial flap is a recognized technique for nasal reconstruction.
• Its full potential and diverse applications in reconstructing various nasal defects are often underestimated.
• A structured approach is needed to guide its use.

Purpose of the Study:

• To showcase the wide range of applications for the nasolabial flap in nasal defect reconstruction.
• To introduce a novel, defect-based algorithm for selecting the appropriate nasolabial flap technique.
• To evaluate patient and surgeon satisfaction with this reconstructive method.

Main Methods:

• A retrospective case series of 23 patients undergoing nasal reconstruction with a nasolabial flap between 2014 and 2024.
• Data collected included patient demographics, defect characteristics, flap details, and outcomes.
• Flap applications were categorized into eight variants based on defect analysis (subunit, depth, complexity).

Main Results:

• Nasal defects were primarily due to skin cancer resection (91.3%).
• Defects ranged from partial to full-thickness and single to multi-subunit.
• No major complications or flap losses were reported, with high patient satisfaction and minimal need for revision surgery.

Conclusions:

• The nasolabial flap is a versatile and straightforward option for routine facial reconstruction.
• The proposed defect-based algorithm facilitates precise decision-making for reconstructive surgeons.
• This approach enhances the effective utilization of the nasolabial flap in clinical practice.