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Combination of Melolabial Interpolation Flap and Nasal Sidewall and Cheek Advancement Flaps Allows for Repair of Complex Compound Defects

Patel, Payal M., BS*; Greenberg, Judah N., MD*; Kreicher, Kathryn L., MD; Burkemper, Nicole M., MD*; Bordeaux, Jeremy S., MD, MPH; Maher, Ian A., MD*

doi: 10.1097/DSS.0000000000001471
Original Article

BACKGROUND The paramedian forehead flap (PMFF) is the repair of choice for large nasal defects involving multiple cosmetic subunits. However, the PMFF may not be optimal for all patients. The combination of a melolabial interpolation flap (MLIF) and a nasal sidewall flap may serve as an alternative.

OBJECTIVE To present the surgical technique and aesthetic outcomes of the alternative reconstruction for surgical defects of the lower nose.

MATERIALS AND METHODS Fourteen patients with multisubunit nasal Mohs defects reconstructed alternatively were identified from 2 academic centers in this retrospective case series. Illustrations and photographs were used to demonstrate surgical technique and outcomes. Final aesthetic results were analyzed using the Patient and Observer Scar Assessment Scale.

RESULTS The physician observer rated the scar outcome a mean score of 10.9 ± 3.3. Patients rated their results as a mean of 9.1 ± 4.7. The mean “Patient” Overall Opinion score was 2.3 ± 2.6 and the mean “Observer” Overall Opinion score was 1.9 ± 0.9. No patients reported problems with nasal airflow or obstruction, and cosmetic complications such as pincushioning or alar buckling were not observed.

CONCLUSION The combined MLIF and nasal sidewall flap is an alternative repair for complex distal nasal defects.

*Department of Dermatology, St. Louis University School of Medicine, St. Louis, Missouri;

Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, Ohio

Address correspondence and reprint requests to: Ian A. Maher, MD, Anheuser-Busch Institute, 1755 S. Grand Boulelvard, Room 210, St. Louis, MO, 63104, or e-mail:

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the full text and PDF versions of this article on the journal's Web site (

The authors have indicated no significant interest with commercial supporters.

© 2018 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.
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