Background Although many trials have been made to augment the unilateral alar base depression, the ultimate aesthetic satisfaction has proven difficult to achieve. In our study, we present a novel submucosal dissection technique to harvest the vomer bone and use it as an onlay graft to correct the alar base depression. Methods We collected a prospective cohort study of 11 patients with unilateral cleft lip nasal deformity. Using CorelDRAW X7 software, we obtained perioperative clinical photographs to analyze the nostril and lateral lip morphometric measurements on the cleft side. Computed tomography scans were used to assess the required graft's volume and to detect resorption. We performed vomerine ostectomy and placed and fixed the bone graft in with a lag screw over the alar base depression. Results The nostril width showed a significant increase, in addition to the height/width ratio. The columellar angle with the lateral lip height increased remarkably, with a general improvement in the nasal tip aesthetics. Conclusions The vomer bone graft has been shown to correct the lateral and inferior disorientation of the alar base and improve the nostril and nasal tip aesthetic measurements. The vomer bone is therefore a sufficient bone source for grafting with high viability and no resorption.

Introduction The lateral malleolar region is a prominent anatomic structure vulnerable to repetitive trauma and ulcer formation. The abductor digiti minimi (ADM) muscle flap offers a promising treatment option for the reconstruction of small- to moderate-sized defects that have exposed bone, joint, or tendons in the lateral malleolar area. Methods Between 2013 and 2016, 8 patients with foot ulcers were reconstructed with ADM muscle flap. The muscle component of the flap obliterated the dead space and provided a vascularized muscle over the debrided ankle joint. When it is needed, the flap is covered with a small split-thickness skin graft. Results In all cases, complete healing was achieved. The muscle flap functioned well as a versatile and shock absorbent coverage without recurrence of the ulcer during a mean follow-up period of around 2 years. Conclusions Coverage of a soft tissue defect at the lateral side of the ankle remains a challenge for surgeons because of the limited possibilities for local transposition. Free flaps have frequently been associated with postoperative complications and higher costs. Also, not all patients are suitable candidates for free tissue transfer because of existing comorbidities. Coverage with a split-thickness skin graft will not be possible for wounds with exposed bone or neurovascular structures or in wounds involving the weight bearing surface of the foot. Using ADM muscle offers no donor site morbidity, good soft tissue coverage, and an effective healing process. Also, no limb movement affection and normal daily life are acquired.

Background: Different autologous materials are recently used in the purpose of augmentation of the nasal dorsum. Despite the benefits and drawbacks, nasal reconstruction with autologous tissue remains a better method for excellent results and lower morbidity rates. Methods: The authors harvested conchal cartilage from the ears and use it after dicing. The superficial temporal fascia was harvested from the temporal region. Diced cartilage was wrapped with superficial temporal fascia, making a roll. After creating a cavity in the nasal dorsum, the combined roll graft was inserted over the nasal dorsum in a “caterpillar” fashion. The authors have operated on 18 patients of secondary nasal deformity cases. Results: The results were excellent in most of the cases. This procedure presented many advantages: optimum nasal contouring, satisfactory volume for the nasal dorsum, and with low rates of infection and exposure. Conclusions: Nasal deformities were reconstructed using crushed cartilage harvested from the concha and enclosed in temporal fascia. This procedure could provide more psychologic comfort and long-lasting appearance.

Background: The management of lower eyelid ectropion is considered a challenge. Lower eyelid ectropion is conventionally reconstructed with a full-thickness skin graft or a local flap. However, complications as scar contracture and the recurrence of ectropion frequently occur. This article describes an effective surgical technique for ectropion correction using an upper eyelid as the laterally based orbicularis oculi myocutaneous flap. Methods: The flap was used in 7 patients who were subjected to lower eyelid reconstruction. A strip of unipedicled orbicularis oculi myocutaneous flap from the lateral canthus was elevated and transposed to the lower eyelid to suspend the lower eyelid and repair the skin defect. Results: Satisfactory eyelid function and cosmetic appearance were obtained and no recurrence was found in 2-years follow-up. The method proved that the donor scar was well hidden in the supratarsal crease. Mild flap color change occurred in the early stages but disappeared gradually within 2 months after. Conclusions: The use of this flap not only gives similar tissue reconstruction, additional support, well-hidden scar, and no loss of function, but also fast flap rising with the reliable donor. With a thorough knowledge of anatomy, the authors believe that their technique described below will expand anatomical understanding and powerful reasons for using laterally based orbicularis oculi myocutaneous flap for not only reconstructive but also aesthetic surgeons.