Nasalis Myocutaneous Island Pedicle Flap with Bilevel Undermining for Repair of Lateral Nasal Defects

Abstract

The nasalis myocutaneous island pedicle flap with bilevel undermining, a new method for repair of lateral nasal defects at or above the alar groove, yields excellent functional and cosmetic results. Bilevel undermining is a new and valuable method of achieving greater tissue mobility in muscle-based flaps.

Tunneled Transposition Flap for Reconstruction of Defects of the Nasal Ala

“…Island pedicle flaps have also been described for the repair of deep alar defects. 3,4 Unilateral or bilateral island pedicle flaps can provide reasonable cosmetic results, but they are limited in that the defect must be very small to achieve optimal cosmesis. 3 For larger defects, it can be difficult to generate the flap mobility required to close the defect.…”

“…Some authors have recommended larger superiorly based island pedicle flaps to close nasal alar defects. 4 With this approach, however, the alar crease is violated. In contrast, with the tunneled transposition flap, the alar crease remains entirely preserved.…”

The Interposed Nasalis Myocutaneous Island Flap for Lesions of the Ala and Lateral Tip of the Nose

“…As Papadoupoulos and Trinei [3] and Papadoupoulos et al [4] have described, the m. nasalisis a valuable pedicle for skin flaps. Defects on the lateral tip of the nose as well as the ala are difficult to reconstruct.…”

“…In some island pedicle flaps, the pedicle is defined by subcutaneous fat tissue which is under the flap (island pedicle flap at the skin of the extremities, trunk and cheek); others present a lateral myocutaneous pedicle as the nasalis myocutaneous island pedicle flap for nasal tip or lateral nasal defects or in eyebrow reconstruction [2,3,4]. The anatomy and technique of this flap are well described in several textbooks.…”

Rotation Flap Reconstruction for Nasal Tip Defect after Mohs Surgery

“…Nasal tip lesions are subject to a lot of controversies over possible reconstructions [1,2,3,4]. A nasal tip defect of small size can easily be reconstructed by a transposition flap, an island pedicle flap or a dorsal nasal advancement flap but with the inconvenience that the incision lines are not following anatomical subunits [1, 2].…”