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The Spiral Flap for Nasal Alar Reconstruction: Our Experience with 63 Patients

Mahlberg, Matthew J., MD1; Leach, Brian C., MD1; Cook, Joel, MD1

doi: 10.1111/j.1524-4725.2011.02177.x

Objective To describe our patient selection, design, execution, and results with the spiral flap for distal nasal surgical defects after Mohs micrographic surgery.

Materials and Methods We performed a retrospective analysis of all spiral flaps performed over a 5-year period. Sixty-three patients were identified, and charts and photographs were examined. Surgical defects were classified according to alar location. All follow-up encounters were reviewed to assess for complications and need for revisionary procedures. Intraoperative photographs were taken of representative cases to describe the surgical technique.

Results Sixty-three patients on whom the spiral flap was performed were identified over a 5-year period. The flap was used to successfully reconstruct alar defects ranging in size from 5 to 15 mm in diameter. No persistent complications were noted.

Conclusion The spiral flap is a reproducible, one-stage flap for small to medium-sized defects of the nasal ala and alar groove that consistently produces topographic restoration with minimal risk of aesthetic or functional complication.

1Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina,

Address correspondence and reprint requests to: Joel Cook, MD, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, 135 Rutledge Avenue, Charleston, SC 29403, or e-mail:

The authors have indicated no significant interest with commercial supporters.

© 2012 by the American Society for Dermatologic Surgery, Inc.
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