The subcutaneous melolabial island flap for nasal alar reconstruction: a clinical review with nuances in technique

The Laryngoscope
R L Arden, George S Miguel

Abstract

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 a...Continue Reading

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Citations

Oct 19, 2010·Journal of the American Academy of Dermatology·James O Barlow
Oct 27, 2016·International Journal of Oral and Maxillofacial Surgery·A GhassemiA Modabber
Mar 24, 2017·JAMA Facial Plastic Surgery·Waleed H Ezzat, Sara W Liu
Jul 25, 2019·Plastic and Reconstructive Surgery. Global Open·Rafaella GenovaKongkrit Chaiyasate
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Feb 20, 2021·Otolaryngologic Clinics of North America·Issam N Eid, Oneida A Arosarena

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