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CC BY 4.0 · Arch Plast Surg 2024; 51(05): 480-486
DOI: 10.1055/a-2337-2131
Pediatric/Craniomaxillofacial/Head and Neck
Idea and Innovation

A Lifeboat for Failed Nasal Reconstructions: The Supraclavicular–Submental Sandwich Flap

Michel L.H.T. Vaena 
1   Faculdade de Ciências Médicas (FCM), Rio de Janeiro State University (UERJ), Rio de Janeiro, RJ, Brazil
,
Kevin Sicalo 
2   Hospital Universitario Pedro Ernesto, UERJ, Rio de Janeiro, RJ, Brazil
,
Caterina Goulart Alessio 
2   Hospital Universitario Pedro Ernesto, UERJ, Rio de Janeiro, RJ, Brazil
,
Eduardo Pantoja Bastos 
2   Hospital Universitario Pedro Ernesto, UERJ, Rio de Janeiro, RJ, Brazil
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Abstract

Many failures in total or subtotal nasal reconstruction result from an underestimation of the amount of skin required for an adequate result, especially for sufficient lining. Such planning errors usually lead to poor results, with exposure of structural grafts, infection, scar retraction, airway obstruction, and finally loss of projection and shape of the reconstructed nose. Reconstruction options for cases in which previous attempts have failed are always limited, as well as in cases of trauma or burns affecting the soft tissues of the forehead and face. In such complex situations, one may employ free flaps or tissue expansion, but such resources may not be always available. We describe a technique indicated for salvage surgeries in patients whose previous nasal reconstructions have failed, allowing a generous amount of tissue transfer for the nasal region. The technique combines the use of supraclavicular and submental flaps, with simple execution, not requiring microsurgical skills or devices such as tissue expanders. Done in three stages, the described technique provides enough skin for a total nasal reconstruction. The final result is obtained after subsequent refinements, and the total number of procedures is equivalent to when more sophisticated techniques are employed, such as tissue expansion or microsurgery.

Keywords

surgical flaps - reconstructive surgical procedures - nose deformities - acquired

Authors' Contributions

ML.H.T.V.: conceptualization, project administration, writing original draft, reviewing, and editing. K.S./C.G.A.: visualization, data curation, and writing original draft. E.P.B.: visualization, data curation, and project administration.


Ethical Approval

This study was study was conducted in accordance with the Declaration of Helsinki (as revised in 2013) and approved by the Institutional Review Board of Pedro Ernesto University Hospital (No. 5.746.423: the registration number of the ethics board).


Patient Consent

The patients' consent was obtained for their clinical photographs and videos for academic purposes.




Publication History

Received: 19 September 2023

Accepted: 30 May 2024

Accepted Manuscript online:
03 June 2024

Article published online:
09 August 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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