PMC5726710_01
A - Surgical defect affecting 70% of the right ala.
Nasolabial interpolation flap design. Note demarcation of the
remaining subunit to be excised. B - Immediate
postoperative (1st stage)
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The resulting defect measured 1.6 x 1.7 cm (Figure 2). A defect template was created based on the contralateral ala, and demarcated on the nasolabial fold, connected to the pedicle (Figure 2). The nasolabial fold was closed primarily in three layers (Figure 2).
Nine months postoperatively. Note incision lines hidden between the
limits of the nasal subunits. Also note the adequate recreation of
the alar crease
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PMC5726710_01_abd-92-05-s1-0159-g03.jpg
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Nine months postoperatively, the patient had a good result with maintenance of function, alar lobule restoration, and alar crease preservation (Figure 3).
PMC5726710_02
A - Surgical defect affecting 90% of the right ala,
inferior portion of the nasal sidewall and medial cheek. The
remaining portions of the ala are marked to be removed. B
- Parts of the different subunits are demarcated for
adequate planning: nasal sidewall (white), medial cheek (green) and
nasal ala (yellow)
abd-92-05-s1-0159-g04.jpg
PMC5726710_02_abd-92-05-s1-0159-g04.jpg
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After two stages of Mohs micrographic surgery, clear margins were achieved resulting in a 2.7 x 2.5 cm defect (Figure 4).
Immediate postoperative of nasolabial interpolation flap (1st stage).
Nasal sidewall and cheek were closed primarily (black arrow) leaving
the inferior portion to heal by second intention (white arrow)
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PMC5726710_02_abd-92-05-s1-0159-g05.jpg
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The ala had its remaining portion removed and was restored with a nasolabial interpolation flap associated with a cartilage graft (Figure 5).
Two months postoperatively. A - Oblique view. B
- Frontal view. C - Inferior view. Note
adequate patency of the nasal vestibule
abd-92-05-s1-0159-g06.jpg
PMC5726710_02_abd-92-05-s1-0159-g06.jpg
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