PMC3591078_01
Preoperative frontal view of the patient
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F1
A 14-year-old boy, child of non-consanginous parents reported to our centre with complaints of unaesthetic appearance of the nose [Figure 1].
Illustration showing the incision markings
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F2
The markings for the incision were placed as shown in Figures 2 and 3 and the first full-thickness incision was placed on the anterior border of the lateral alar margin of the cleft extending from point A to point B as shown in Figures 4 and 5.
Intraoperative view with incision markings
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F3
The markings for the incision were placed as shown in Figures 2 and 3 and the first full-thickness incision was placed on the anterior border of the lateral alar margin of the cleft extending from point A to point B as shown in Figures 4 and 5.
Intraoperative view after full-thickness flap elevation
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F4
The markings for the incision were placed as shown in Figures 2 and 3 and the first full-thickness incision was placed on the anterior border of the lateral alar margin of the cleft extending from point A to point B as shown in Figures 4 and 5.
Illustration showing the repositioned second full-thickness flap
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F5
The markings for the incision were placed as shown in Figures 2 and 3 and the first full-thickness incision was placed on the anterior border of the lateral alar margin of the cleft extending from point A to point B as shown in Figures 4 and 5. The incision from point C to point D placed on the medial side of the alar cleft leads to a full-thickness flap that is rotated in a lateral direction to close the "V"-shaped surgical defect [Figure 5].
Illustration showing the completed reconstruction
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F6
Closure was done in layers with simple interrupted sutures, muscle layer closed with 4-0 vicyrl and skin with 5-0 prolene as shown in Figures 6 and 7.
Immediate postoperative picture
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F7
Closure was done in layers with simple interrupted sutures, muscle layer closed with 4-0 vicyrl and skin with 5-0 prolene as shown in Figures 6 and 7.
Postoperative frontal view after 2 years
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F8
The patient has been followed up for the past 2 years and the esthetic outcome of the surgery has been satisfactory for the patient and the surgeon as shown in Figure 8.