The authors have no funding, financial relationships, or conflicts of interest to disclose.
Facial Plastics and Reconstructive Surgery
The subcutaneous melolabial island flap for nasal alar reconstruction: A clinical review with nuances in technique†
Article first published online: 7 MAY 2012
Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 122, Issue 8, pages 1685–1689, August 2012
How to Cite
Arden, R. L. and Miguel, G. S. (2012), The subcutaneous melolabial island flap for nasal alar reconstruction: A clinical review with nuances in technique. The Laryngoscope, 122: 1685–1689. doi: 10.1002/lary.23377
- Issue published online: 25 JUL 2012
- Article first published online: 7 MAY 2012
- Manuscript Accepted: 30 MAR 2012
- Manuscript Revised: 12 MAR 2012
- Manuscript Received: 9 FEB 2012
- Melolabial flap;
- island flap;
- alar defect;
- Level of Evidence: 4
To describe our experience with surgical reconstruction of whole subunit nasal alar skin losses following Mohs ablative surgery, using a subcutaneous melolabial island flap with emphasis on a simplified technique to minimize facial scarring and optimize facial contour.
Retrospective review of case series.
A single surgeon's results in 48 consecutive patients spanning 7 years were analyzed by comprehensive chart review. Details of wound site and flap-specific complications were noted. Favorable nuances in surgical technique differing from standard approaches are graphically described.
Loss of melolabial sulcal depth was the most commonly seen donor-site complication (8%). No cases of flap compromise were seen. An unexpectedly high frequency of subjective nasal obstruction was seen (37%) after the second stage, more common when cartilage grafts were underutilized, and with through-and-through defects at inception. External contour was uniformly good to excellent.
The described variation in subcutaneous melolabial island flap transfer provides reliable soft tissue replacement for whole subunit alar skin losses with favorable donor-site scarring and resultant contour. Attention to proper utilization of supportive cartilage grafts and ancillary debulking procedures is often necessary to optimize functional outcomes. Laryngoscope, 2012