Reconstruction of nasal tip defects by dorsonasal V-Y advancement island flap

The nasalis musculocutaneous sliding flap developed by Rybka and the myocutaneous axial flap with lateral pedicle reported by Martire and associates are extremely useful for reconstruction of the nasal tip and surrounding area, respectively. We have modified the method of Martire and associates into an operative procedure that can be easily employed. By confirming the blood flow of the lateral nasal artery preoperatively by Doppler probing, the lateral pedicle of the flap was made smaller to facilitate mobilization of the flap. Furthermore, this flap could be made into a reversed-flow flap when indicated.