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CC BY-NC 4.0 · Arch Plast Surg 2018; 45(03): 253-258
DOI: 10.5999/aps.2017.00878
Original Article

Delayed bipedicled nasolabial flap in facial reconstruction

Cindy Siaw-Lin Goh
Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital, Singapore, Singapore
,
Joshua Guy Perrett
Department of General Surgery, Waitemata District Health Board, Auckland, New Zealand
,
Manzhi Wong
Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital, Singapore, Singapore
,
Bien-Keem Tan
Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital, Singapore, Singapore
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Background The nasolabial flap is ideal for reconstruction of the nasal alar subunit due to its proximity, color and contour match, and well-placed donor scar. When raised as a random-pattern flap, there is a risk of vascular compromise to the tip with increased flap length and aggressive flap thinning. Surgical delay can greatly improve the chances of tip survival, allowing the harvest of longer flaps with greater reach.

Methods We describe our technique of lengthening the nasolabial flap through multiple delay procedures. A bipedicled flap was first raised and then transferred as a unipedicled flap with a 6:1 length-to-width ratio. During the delay process, the flap tip was thinned to the subdermal layer.

Results In our case series of seven patients, defects as far as the medial canthal area and contralateral ala were reconstructed successfully with no incidence of tip necrosis or flap loss. The resultant flaps were thin enough to be folded over for the reconstruction of alar rim defects.

Conclusions We highlight the success of our surgical technique in creating thin and robust nasolabial flaps for the reconstruction of full-thickness defects around the nose.

Keywords

Reconstructive surgical procedures - Surgical flaps - Nasolabial fold - Graft survival

We thank Evan Lim Hock Tat for his assistance with the design of the medical illustration (Fig. 4, original creation).




Publication History

Received: 19 May 2017

Accepted: 09 January 2018

Article published online:
03 April 2022

© 2018. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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