Arch Plast Surg.  2019 Sep;46(5):480-483. 10.5999/aps.2018.01354.

A new flap combination for reconstruction of lower nasal dorsum and supra-tip skin defects

  • 1Department of Oral and Maxillofacial, Estaing Hospital, CHU Clermont-Ferrand, Clermont-Ferrand, France.
  • 2University of Auvergne Faculty of Medicine, Clermont-Ferrand, France.
  • 3Department of Dermatology, Estaing Hospital, CHU Clermont-Ferrand, Clermont-Ferrand, France.
  • 4UMR Inserm U1107, Neuro-Dol, Trigeminal Pain and Migraine, Faculty of Dentistry, University of Auvergne, Clermont-Ferrand, France.
  • 5CROC EA 3847 Laboratory, Faculty of Dentistry, University of Auvergne, Clermont-Ferrand, France.
  • 6INSERM, CHU Lille, U1008–Controlled Drug Delivery Systems and Biomaterials, University of Lille, Lille, France.


Repairing surgical defects of the nose is still challenging due to its tridimensional shape and its aesthetic concern. Difficulty in reconstructing nasal subunits lies in their contour, skin texture and limited availability of adjacent skin. For lower nasal dorsum and supra-tip regions, we design a new combined local flap as existing local flaps may give disappointing results. This combination flap was performed on two patients for reconstruction of the lower nasal dorsum area after basal cell carcinoma excision. Size of the excision ranged from 20 to 25 mm diameter and safe margins were obtained. The defects were reconstructed with a local flap that combined a rotation nasal flank flap and a V-Y advancement nasolabial flap. Excision and reconstruction were performed in a one-stage surgery under intravenous sedation and local anesthesia. There were no postoperative complications and no flap loss occurred. Aesthetic and functional results after 6 months postoperatively were satisfying without modification of nasal shape. This flap is reliable and offers interesting functional and aesthetic outcomes. It can be considered as a new reconstruction alternative for supra-tip and lower nasal dorsum skin defects performed in a one-stage procedure under local anesthesia.


Nose defect; Supra-tip; Aesthetic subunit; Flap

MeSH Terms

Anesthesia, Local
Carcinoma, Basal Cell
Postoperative Complications
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