Two-Stage Interpolated Nasolabial Island Flap and Conchal Cartilage Graft

Abstract

A variety of techniques have been reported for ala reconstruction. In defects involving more than 50 % of a subunit, Burget and Menick recommend excising the remainder of the skin envelope subunit and replacing its entire unit. This provides the optimal a esthetic result. In our case, to reconstruct a subtotal nasal ala defect with intact lining, we choose a two-stage interpolated nasolabial island flap and conchal cartilage graft. The advantages of using such flap are the local proximity of the skin and hence the similarity in skin color, texture, and thickness; and the inconspicuous donor scar in the depth of the nasolabial fold. A two-stage interpolating flap achieves a superior aesthetic alar subunit reconstruction by bridging the flap over and preserving the alar facial sulcus. Conchal cartilage graft, which is curved, resembles the natural curve of the alar and is ideal for preserving contour and structural integrity to alar defect. The underlying graft provides both aesthetic reconstruction and external nasal valve competence, resisting the forces of scar construction.