Correction of Severe Alar Retraction with Use of a Cutaneous Alar Rotation Flap

Isolated congenital alar rim defects are extremely rare, and there has been no standard technique for the reconstruction of remarkable aesthetic deformity. Herein, we introduce a trifoliate flap for the correction of isolated congenital alar rim defects in pediatric patients. Fifteen cases undergoing nasal alar sulcus rotation flap surgery were analyzed retrospectively. This rotation flap including 3 triangles was a modified flap based on prior studies. Clinical medical notes and photographs were reviewed. Patients’ (or their parents) reported satisfactions with aesthetic outcome were also evaluated during the post-operative follow-up period. In all patients, the isolated congenital alar rim defects were successfully reconstructed. The rotation flap survived and the wound healed primarily. The follow-up period ranged from 6 to 22 months (average 11 months). There were no incidents of flap loss, step-off deformities, nasal obstruction, or alar retraction. At follow-up of post-operative 3 months, pale red scars were observed in the operative area in few patients (2/15). However, these scars gradually became invisible at post-operative 6 months. All patients (or their parents) were satisfied with the aesthetic outcome of this operation. This newly designed trifoliate flap can be an alternative method for the reconstruction of isolated congenital alar rim defects in pediatric patients. The scars of this procedure can be unobvious with fine surgical suture.

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Island Rotation Flap for Nasal Reconstruction

Yearbook of Plastic and Aesthetic Surgery ◽

10.1016/s1535-1513(08)70062-6 ◽

2007 ◽

Vol 2007 ◽

pp. 69

Author(s):

R.L. Ruberg

Keyword(s):

Nasal Reconstruction ◽

Rotation Flap

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Extended rotation flap for reconstruction of partial thickness defects of the tip and nasal ala region: in search of better aesthetic results

JPRAS Open ◽

10.1016/j.jpra.2021.05.004 ◽

2021 ◽

Author(s):

Annachiara Cavaliere ◽

Barbara Maisto ◽

Tatiana Zaporojan ◽

Ludovica Giordano ◽

Luigi Sorbino ◽

...

Keyword(s):

Rotation Flap ◽

Partial Thickness ◽

Nasal Ala ◽

Aesthetic Results

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Caudal Extension Graft of the Lower Lateral Cartilage: Technique and Aesthetic and Functional Results

Facial Plastic Surgery ◽

10.1055/s-0041-1726025 ◽

2021 ◽

Author(s):

Juliano de Oliveira Sales ◽

Wolfgang Gubisch ◽

Rodrigo Ribeiro Ferreira Duarte ◽

Aline Souza Costa Teixeira Moreno ◽

Felipe Marques de Oliveira ◽

...

Keyword(s):

Patient Satisfaction ◽

Age Groups ◽

Functional Results ◽

First Year ◽

Lateral Cartilage ◽

Lower Lateral Cartilage ◽

Alar Retraction ◽

Outcomes Evaluation ◽

A New Technique ◽

Extension Graft

AbstractHere we describe a new technique to deal with alar retraction, a highly undesirable imperfection of the nose. The procedure involves placing a caudal extension graft below the vestibular portion of the lower lateral cartilage (LLC) after its detachment from the vestibular skin. The graft is fixed to the cartilage and, subsequently, to the vestibular tissue. The present retrospective study included 20 patients, 11 females and 9 males, with a mean age of 28.90 years. Follow-up ranged from 1 to 18 months. Surgery improved alar notching to a smoother dome shape and nostril exposure was reduced in every patient. The caudal extension graft of the LLC contributed to rise in overall patient satisfaction, as revealed by the postoperative increase of the Rhinoplasty Outcomes Evaluation (ROE) mean score from 40.0 to 79.17 (p < 0.0001). It also contributed to and improved functional outcomes, as indicated by the decrease of the Nasal Obstruction Symptom Evaluation (NOSE) mean score from 52.75 to 13.25 (p = 0.0001). Sex did not affect the mean ROE and NOSE scores. Thus, increased patient satisfaction measured by the ROE is present in both sexes and at both age groups but it is better detected in the first year after surgery. Functional improvements analyzed with NOSE are best detected in patients aged ≥ 30 years and in follow-ups of 11 months. The caudal extension graft of the LLC technique described herein effectively and safely corrects alar retraction and the collapse of the nasal valve while filling the soft triangle.

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Combined Cutaneous Rotation Flap and Myomucosal Tongue Flap for Reconstruction of an Upper Lip Defect

Actas Dermo-Sifiliográficas (English Edition) ◽

10.1016/j.adengl.2014.09.017 ◽

2014 ◽

Vol 105 (9) ◽

pp. 869-871

Author(s):

A.F. Massa ◽

M. Otero-Rivas ◽

B. González-Sixto ◽

M.Á. Rodríguez-Prieto

Keyword(s):

Upper Lip ◽

Rotation Flap ◽

Tongue Flap ◽

Lip Defect

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Bilateral Vermilion Rotation Flap

Dermatologic Surgery ◽

10.1111/j.1524-4725.2006.32145.x ◽

2006 ◽

Vol 32 (5) ◽

pp. 721-725 ◽

Cited By ~ 5

Author(s):

ANDREW J. KAUFMAN

Keyword(s):

Rotation Flap

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Scalp Reconstruction Following High Voltage Electric Burn

Bangladesh Journal of Plastic Surgery ◽

10.3329/bdjps.v3i2.18251 ◽

2014 ◽

Vol 3 (2) ◽

pp. 49-52 ◽

Cited By ~ 1

Author(s):

Md Zakir Hossain ◽

Bidhan Sarker ◽

Lutfar Kader Lenin ◽

Ayesha Hanna ◽

Limon Kumar Dhar

Keyword(s):

Plastic Surgery ◽

High Voltage ◽

Skin Grafting ◽

College Hospital ◽

Transposition Flap ◽

Reconstructive Procedures ◽

Rotation Flap ◽

Medical College ◽

Scalp Reconstruction ◽

Scalp Defects

Background: Scalp reconstruction following high voltage electric burn can be challenging. A useful Reconstructive algorithm is lacking. The purpose of this study was to evaluate our experience and to identify an appropriate reconstructive strategy. Methodology: This was a prospective observational study, conducted in the Burn unit of Dhaka Medical College Hospital & Department of Burn & Plastic Surgery,Sir Salimullah Medical College & Mitford Hospital over a period of five years. Reconstructive procedures, independent factors and outcomes were evaluated. A total of 7 procedures were performed in 30 patients. Techniques for reconstruction included skin grafting, outer table drilling & skin grafting, Bipedicle flap, Single rotation flap, Double opposing rotation flap, Transposition flap, Tissue expansion & primary closure. Conclusion: Important tenets for successful management of scalp defects are durable coverage, adequate debridement, preservation of blood supply, and proper wound drainage. Local scalp flaps with skin grafts remain the mainstay of reconstruction in most instances. DOI: http://dx.doi.org/10.3329/bdjps.v3i2.18251 Bangladesh Journal of Plastic Surgery July 2012, 3(2): 49-52

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