The superiorly based bilobed flap for nasal reconstruction

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BackgroundThe laterally based bilobed flap is commonly used for the reconstruction of small- to medium-sized defects of the distal portion of the nose; However, when this flap is used to repair defects that are larger, more cephalic, or more lateral on the nose, there is a risk for lower nasal distortion. Reorienting the base superiorly preserves the advantages of the traditional design while minimizing this risk.ObjectiveTo demonstrate the design, execution, and efficacy of the superiorly based bilobed flap.MethodsA retrospective review examined all superiorly based bilobed flaps performed by 1 surgeon (J.C.) in 2000-2016 after tumor extirpation by Mohs micrographic surgery at a single institution.ResultsA total of 41 surgical defects were closed with 40 flaps between June 2000 and August 2016 (1 patient had 2 defects closed with a single flap). Of the tumors, 55% were located on the nasal dorsum, and the median of the longest postoperative tumor axis was 1.4 cm. Follow-up was available for 40 flaps, and no infections, hematomas, or episodes of full-thickness necrosis were observed.LimitationsData were collected retrospectively from a single institution without a standardized assessment tool for aesthetic outcomes.ConclusionThe superiorly based bilobed flap is useful for nasal reconstruction.

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