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Reconstruction of Large Nasal Defects with a Combination of Local Flaps Based on the Aesthetic Subunit Principle

Yotsuyanagi Takatoshi M.D. Ph.D.; Yamashita, Ken M.D.; Urushidate, Satoshi M.D.; Yokoi, Katsunori M.D., Ph.D.; Sawada, Yukimasa M.D., Ph.D.
Plastic and Reconstructive Surgery: May 2001
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Herein is described a technique that uses a combination of local flaps to reconstruct large defects involving the nasal dorsum and cheek. The flaps used are a transposition flap elevated from the area adjoining the defect and bilateral cheek advancement flaps. This technique leaves all suture wounds at borders of the aesthetic subunits that have been described previously. Color and texture matches were good and symmetrical. The transposition flap can be modified according to whether the defect includes the nasal tip. After raising the cheek advancement flap, it is also possible to use a dog-ear on the nasolabial region for any alar defects. Nine patients were treated using this procedure. The technique is very reliable (no complications such as congestion and skin necrosis in our series) and is easy to perform. One patient had palpebral ectropion after the operation and underwent secondary repair. In this series, defects measuring 45 × 30 mm in maximum diameter and including the nasal dorsum, nasal tip, ala, and cheek were treated. (Plast. Reconstr. Surg. 107: 1358, 2001.)

Takatoshi Yotsuyanagi, M.D.

Department of Plastic and Reconstructive Surgery

Hirosaki University School of Medicine

5 Zaifu-cho, Hirosaki, 036-8216, Japan

From the Department of Plastic and Reconstructive Surgery, Hirosaki University School of Medicine. Received for publication June 13, 2000; revised July 31, 2000.

©2001American Society of Plastic Surgeons