Reconstruction of a Nasal Alar Defect, Melolabial Interpolation Flap

Abstract

Reconstruction of the nasal alar subunit brings with it several distinct considerations and challenges. Primary of those, is the necessity to maintain structural support for nasal airflow through the external nasal valve. Additionally, the need for maintenance of a distinct alar groove eliminates many options for moving local flaps down from the nasal sidewall or sliding flaps over from the cheek. And finally, the free margin of the alar rim is prone to displacement with even a small amount of tension, which can easily result in alar retraction or alteration of alar shape. Interpolating skin from the melolabial region allows for preservation of the alar groove while transporting in vascular skin that can be contoured to the depth of the defect, and that can nourish structural cartilage grafts.