Treatment of Trapdoor Deformity Using Erbium-doped Yttrium Aluminum Garnet Laser

Feng, Hao; Christman, Mitalee P; Bloom, Bradley S.; Brown, William E; Geronemus, Roy G.

doi:10.1097/gox.0000000000002445

Cited by 3 publications

(7 citation statements)

References 2 publications

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“…Laser treatment is ideal for revision, as it minimizes the interruption of patients' daily routines. Two articles reported a high patient satisfaction after nasal bilobed flap reconstruction with PDL or Er: YAG laser 16,17 …”

Section: Discussionmentioning

confidence: 99%

“…Two articles reported a high patient satisfaction after nasal bilobed flap reconstruction with PDL or Er: YAG laser. 16,17 A 585-nm PDL causes selective photothermolysis, which targets hemoglobin rather than tissues. It is the recommendation for cutaneous vascular lesions such as telangiectasia and erythematous scars.…”

Section: Figure 2 Protocol Of the Laser Treatment Combined With Botul...mentioning

confidence: 99%

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Trapdoor Deformity Correction Post Nasal Bilobed Flaps for Basal Cell Carcinoma Reconstruction With Multiple Laser Modalities

Chuang,

Chang,

Huang

et al. 2024

Ann Plast Surg

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In case of excision of nasal basal cell carcinoma (BCC), bilobed flaps are considered the criterion standard of reconstruction for defect less than 15 mm in size. However, there is still a risk of trapdoor deformity formation, of which its treatment is less discussed. A 44-year-old woman who was diagnosed with nasal BCC and underwent tumor excision with bilobed flap reconstruction presented with trapdoor deformity postoperatively. The computed Vancouver Scar Scale was 7. After early intervention of multiple laser modalities, including 2 sessions of 585-nm pulsed dye laser with a fluence of 9 J/cm2, pulse duration of 6 milliseconds, and spot size of 6 mm, 2940-nm Er-yttrium aluminum garnet (YAG) laser with a pulse energy of 800–900 mJ, repetition rate of 8–9 Hz, and laser spot size of 3–7 mm, and 5 sessions of 1064-nm Nd:YAG fractional picosecond laser with a pulse energy of 2.30–2.70 mJ, repetition rate of 8 Hz, and laser spot size of 6 mm from 5 to 23 weeks postoperatively, the Vancouver Scar Scale score improved to 1, with significant reduction of trapdoor scar erythema and puffiness. Although BCC is often curable, tumor excision causes unsatisfactory appearance satisfaction problem, owing to the apparent location of the lesion. Factors, such as sebaceous tissue thickness, reconstruction over multiple aesthetic subunits of nose, and damage to nasal cartilage framework structure during tumor removal, may increase the risk of trapdoor formation. Early intervention with multiple laser treatment can significantly revise the deformity.

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Section: Discussionmentioning

confidence: 99%

Section: Figure 2 Protocol Of the Laser Treatment Combined With Botul...mentioning

confidence: 99%

Trapdoor Deformity Correction Post Nasal Bilobed Flaps for Basal Cell Carcinoma Reconstruction With Multiple Laser Modalities

Chuang,

Chang,

Huang

et al. 2024

Ann Plast Surg

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“…Trapdoor phenomena due to surgery can be found 3 weeks to 6 months postoperatively. 8,9 Prevalence was shown in 397 patients with 97% diagnosed BCC with 66.5% involving the middle canthus showing 15.6% having postoperative complications including graft failure, infection, acute bleeding/hematoma, graft hypertrophy, graft contracture, and trapdoor phenomenon. Another study on the levator labii superioris alaeque nasi flap showed that 5.3% of patients experienced postoperative trapdoor deformity complications.…”

Section: Introductionmentioning

confidence: 99%

Resolving trapdoor-phenomenon without secondary procedure after forehead flap on medial canthal region

Dharmawan¹,

Frieda²,

Julianto³

2023

Dermatol Reports

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Herein, we present a case of Basal Cell Carcinoma (BCC) in a 59-year-old woman. It presented with painless itchy, black, gradually enlarged patches which were easily bled under her left eye since three years ago. Dermatological examination of the left medial canthus region obtained hyperpigmented plaques (2x0.8x0.1cm) with uneven skin texture, irregular borders, and erosion on the center of the lesion. We performed forehead flap technique surgery followed by eight-month monitoring, resulting in a satisfying outcome in both function and appearance. The thinning technique and adjusting the flap size from the forehead area to the medial canthus should be as thin as possible to avoid differences in skin thickness and post-reconstruction hypertrophic scars. A bulging appears on the surgical site a month after the procedure, known as Trap Door Phenomenon. But, on the 8th month of follow-up, the trap drop phenomenon disappeared.

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“…1 Trapdoor deformity is characterized by a bulging elevation of scar tissue above the normal skin surface that results from concentric retraction of curved scars. 2,3 It typically occurs in the nasal area, which is characterized by curved borders and thick, sebaceous skin.…”

mentioning

confidence: 99%

“…However, each modality poses various shortcomings, including variation in efficacy, procedural complexity, postprocedural downtime, complications, and recurrence. 3…”

mentioning

confidence: 99%

How We Do It: Erbium-Doped Yttrium Aluminum Garnet Laser for the Treatment of Postsurgical Trapdoor Deformity

Himeles,

Bajaj,

Bernstein

et al. 2023

Dermatol Surg

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Treatment of Trapdoor Deformity Using Erbium-doped Yttrium Aluminum Garnet Laser

Cited by 3 publications

References 2 publications

Trapdoor Deformity Correction Post Nasal Bilobed Flaps for Basal Cell Carcinoma Reconstruction With Multiple Laser Modalities

Trapdoor Deformity Correction Post Nasal Bilobed Flaps for Basal Cell Carcinoma Reconstruction With Multiple Laser Modalities

Resolving trapdoor-phenomenon without secondary procedure after forehead flap on medial canthal region

How We Do It: Erbium-Doped Yttrium Aluminum Garnet Laser for the Treatment of Postsurgical Trapdoor Deformity

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