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An Alternative to the Median Forehead Flap

Harvey Smith, MBBS, MRCP; Timothy Elliot, MBBS, FACD; Carl Vinciullo, MBBS, FACD

Arch Dermatol. 2003;139:1033-1036.

Objective  To describe our use of cheek-based 2-stage transposition flaps for repairing Mohs surgery defects of the lower third of the nose.

Design  Retrospective case series.

Setting  Private dermatologic day surgery facility.

Patients  Twenty-eight patients with defects of the lower third of the nose after Mohs surgery.

Intervention  Ten alar and 18 nasal tip defects repaired using cheek-based 2-stage transposition flaps.

Main Outcome Measures  Acceptability of procedure to patient, complications, and appearance from photographic records.

Results  The procedures were well tolerated and achieved good cosmetic results without major complications.

Conclusions  These flaps allow repair of extensive defects of the nasal tip and ala with the patient under local anesthesia. This approach provides an alternative to the median forehead flap for nasal tip repairs.

From the Dermatology, Surgery, and Laser Center, Perth Surgicenter, South Perth, Australia. Dr Smith is now with the Department of Dermatology, Royal Hospital Haslar, Hampshire, England. The authors have no financial interest in this article.