SEARCH

SEARCH BY CITATION

Keywords:

  • Melolabial flap;
  • island flap;
  • alar defect;
  • Level of Evidence: 4

Abstract

Objectives/Hypothesis:

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.

Study Design:

Retrospective review of case series.

Methods:

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.

Results:

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.

Conclusions:

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