Use of a helical composite free flap for alar defect reconstruction with a supermicrosurgical technique

The highly contoured nature of the nose and the abundant free margin makes it especially difficult to reconstruct. In this report, we describe the use of a new helical rim free flap technique for the reconstruction of full-thickness nasal alar defects via supermicrosurgery. Briefly, after a wide exc...

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Main Authors: Hyung Hwa Jeong, Dong Hoon Choi, Joon Pio Hong, Hyun Suk Suh
Format: Article
Language:English
Published: Thieme Medical Publishers, Inc. 2018-09-01
Series:Archives of Plastic Surgery
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2017.01270
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author Hyung Hwa Jeong
Dong Hoon Choi
Joon Pio Hong
Hyun Suk Suh
author_facet Hyung Hwa Jeong
Dong Hoon Choi
Joon Pio Hong
Hyun Suk Suh
author_sort Hyung Hwa Jeong
collection DOAJ
description The highly contoured nature of the nose and the abundant free margin makes it especially difficult to reconstruct. In this report, we describe the use of a new helical rim free flap technique for the reconstruction of full-thickness nasal alar defects via supermicrosurgery. Briefly, after a wide excision with a margin of 0.7 cm, an alar defect with a size of 1×1×0.5cm was obtained, which included the full thickness of the skin, mucosa, and lower lateral cartilage. Vessel dissection was performed in a straightforward manner, starting from the incision margin for flap harvest, without any further dissection for reach the greater trunk of the superficial temporal artery. The flap was inset in order to match the contour of the contralateral ala. We closed the donor site via rotation and advancement. No donor site morbidity was observed, despite the presence of a small scar that could easily be covered with hair. The alar contour was satisfactory, and the patient was satisfied with the results. The supermicrosurgical technique did not require further dissection to identify the vessels for anastomosis, leading to better cosmetic outcomes and a reduced operating time.
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spelling doaj.art-612ae95958674ce4a089ede0d29d5e5c2022-12-22T04:23:32ZengThieme Medical Publishers, Inc.Archives of Plastic Surgery2234-61632234-61712018-09-01450546646910.5999/aps.2017.01270965Use of a helical composite free flap for alar defect reconstruction with a supermicrosurgical techniqueHyung Hwa Jeong0Dong Hoon Choi1Joon Pio HongHyun Suk Suh2Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaThe highly contoured nature of the nose and the abundant free margin makes it especially difficult to reconstruct. In this report, we describe the use of a new helical rim free flap technique for the reconstruction of full-thickness nasal alar defects via supermicrosurgery. Briefly, after a wide excision with a margin of 0.7 cm, an alar defect with a size of 1×1×0.5cm was obtained, which included the full thickness of the skin, mucosa, and lower lateral cartilage. Vessel dissection was performed in a straightforward manner, starting from the incision margin for flap harvest, without any further dissection for reach the greater trunk of the superficial temporal artery. The flap was inset in order to match the contour of the contralateral ala. We closed the donor site via rotation and advancement. No donor site morbidity was observed, despite the presence of a small scar that could easily be covered with hair. The alar contour was satisfactory, and the patient was satisfied with the results. The supermicrosurgical technique did not require further dissection to identify the vessels for anastomosis, leading to better cosmetic outcomes and a reduced operating time.http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2017.01270nosefree tissue flapscarcinoma, squamous cell
spellingShingle Hyung Hwa Jeong
Dong Hoon Choi
Joon Pio Hong
Hyun Suk Suh
Use of a helical composite free flap for alar defect reconstruction with a supermicrosurgical technique
Archives of Plastic Surgery
nose
free tissue flaps
carcinoma, squamous cell
title Use of a helical composite free flap for alar defect reconstruction with a supermicrosurgical technique
title_full Use of a helical composite free flap for alar defect reconstruction with a supermicrosurgical technique
title_fullStr Use of a helical composite free flap for alar defect reconstruction with a supermicrosurgical technique
title_full_unstemmed Use of a helical composite free flap for alar defect reconstruction with a supermicrosurgical technique
title_short Use of a helical composite free flap for alar defect reconstruction with a supermicrosurgical technique
title_sort use of a helical composite free flap for alar defect reconstruction with a supermicrosurgical technique
topic nose
free tissue flaps
carcinoma, squamous cell
url http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2017.01270
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