The nasolabial flap: a problem and its correction

The excision of small cutaneous malignancies of the nose frequently results in defects that are appropriate for closure with a nasolabial flap. However, in the older male patient with thick nasal skin, the flap frequently undergoes the trapdoor phenomenon, producing a bulky, unsightly mass. This problem can be corrected, however, by excision of the redundant skin and subcutaneous tissue, leaving a graftable base that can be resurfaced with a full-thickness postauricular skin graft. This method of revision appears superior to just elevating and thinning the flap.