Facial and Nose Reconstruction With a Nasal Labial Flap, Skin Cancer, Kevin Kavanagh
Facial and Nose Reconstruction With a Nasal Labial Flap, Skin Cancer, Kevin Kavanagh
  
Superiorly Based Nasal Labial Flap for Nose Reconstruction in a Patient With Skin Cancer

The tip of this flap was almost lost.  Close patient follow up saved the flap.  The partial necrosis was caused by two factors: The patient started to wear his eyeglasses, with them resting on the base of his flap, and the flap had the maximum length to width ratio of  2.5 to 1.  The necrosis reversed by having the patient stop wearing his eyeglasses and to use pentoxifylline 400 mg t.i.d.  
 

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This patient has a basal cell carcinoma which had been
previously  biopsied.  		The defect after Mohs Surgery.

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The flap is outlined with a length to width ratio of
2.5 to 1.  		 The flap is rotated in place and sewn into position with little tension.

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The flap is sewn in place.  The flap had an excellent blood supply, thus, the 2.5 to 1 ratio was used.  The flap looked excellent 48 hours after surgery, but at 5 days the tip started to die.  Note the indentation on the patient's nose where he has been wearing eyeglasses.   The patient was placed on pentoxifylline 400 mg t.i.d. and instructed to stop wearing his eyeglasses.

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 3 wk post-op result.  Note the flap edema which is often present with superiorly based flaps.  The wearing of eyeglasses will worsen the edema.  The edema should slowly resolve over the course of months.   3 wk post-op result.  Note the flap edema which is often present with superiorly based flaps.  The wearing of eyeglasses will worsen the edema.  The edema should slowly resolve over the course of months.

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 5 month post-op result-angled view.  Note the flap's edema has subsided.    5 month post-op result-side view.  Note the flap's edema has subsided.

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    5 month post-op result-front view.  Note the flap's edema has subsided.

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 9 month post-op result-angled view.     9 month post-op result-side view. 

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    9 month post-op result-front view. 
   
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Copyright  2003    Kevin T Kavanagh, All Rights Reserved 
 

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