The Bilobe Flap for Nasal Reconstruction

Author:

Okland Tyler S.1,Lee Yu Jin1,Sanan Akshay1,Most Sam P.1

Affiliation:

1. Division of Facial Plastic and Reconstructive Surgery, Stanford University, Palo Alto, California

Abstract

AbstractRepair of nasal defects is technically challenging due to inelastic nasal skin and unforgiving nasal geometry. The bilobe flap is a double transposition flap that can transpose skin from cephalad to caudad to repair defects of the lower third of the nose. However, pincushioning may complicate this flap, yielding untoward aesthetic outcomes. We review our single surgeon series of patients who underwent bilobe flap reconstruction of nasal defects, and describe our surgical technique to minimize pincushioning and poor aesthetic outcomes. This was a retrospective chart review of patients who underwent bilobe flap reconstruction of nasal defects at a tertiary referral facial plastic and reconstructive surgery clinic between January 1, 2010 and February 12, 2019. All postoperative clinic notes were analyzed for complications, reports of unfavorable cosmetic outcome, and rates of revision procedures. Surgical technique is described. In the analysis, 125 patients were included, of whom 84 (67%) patients were women, and the mean (standard deviation) age was 60.7 (12.5) years. Complications were reported in 20 (16%) patients, including scars, pincushioning, and nasal obstruction. Five patients underwent revision surgery (4%), including scar revision and z-plasty. Pincushioning was reported in four patients (3.2%), of whom three underwent scar revision procedures. One patient had alar notching requiring correction. There was no statistically significant association between ear cartilage graft and complications (p = 0.84) or requirement of intervention (p = 1.0). Univariate and multivariate logistic regression did not show statistically significant association between size of the defect and the presence of complications (p > 0.05). The bilobe flap is an excellent transposition flap for the repair of small nasal tip defects. By adequately thinning the transposition flap of excess subcutaneous tissue prior to inset, rates of poor aesthetic outcomes, revision procedures, and pincushioning are minimized.

Publisher

Georg Thieme Verlag KG

Subject

Surgery

Cited by 14 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Reconstruction of Isolated Total Lobular Subunit Defect of the Ear;Dermatologic Surgery;2024-08-02

2. Reconstruction of caudal defects of the nose using the bilobe flap: A long-term follow-up retrospective review;Annales de Chirurgie Plastique Esthétique;2024-07

3. Decision Making in Nasal Reconstruction;Facial Plastic Surgery Clinics of North America;2024-05

4. Classification and reconstructive algorithm for nasal alar defect in Asians;Chinese Journal of Plastic and Reconstructive Surgery;2024-03

5. Ästhetische Ergebnisse nach Nasenspitzenrekonstruktionen mit dem Frontonasallappen und anderen lokoregionären Lappen;Handchirurgie · Mikrochirurgie · Plastische Chirurgie;2023-05-24

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