TREATMENT OBSERVATION OF NASAL TIP DEFECTS RECONSTRUCTED BY BILOBED FLAPS AFTER GAINT NEVI EXCISION_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LIZhengyong , PUYi ,  CENYing , WUJunliang , ZHANGZhenyu

Department of Burn and Reconstruction, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China;

Corresponding author：

CENYing, Email: cenying0141@163.com

Keywords：

Nasal tip; Gaint nevi; Bilobed flaps; Wound repair

DOI：

10.7507/1002-1892.20160281

Video：

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Objective To discuss a reliable and aesthetic surgery method for the reconstruction of large defects on the top of nose after giant nevi resection. Methods Between January 2011 and June 2015, 46 cases of nasal tip defects caused by giant nevi resection were treated. Of 46 cases, 22 were male and 24 were female, aged 15-59 years (median, 28 years). The right ala nasi was involved in 28 cases, the apex nasi in 8 cases, and the left ala nasi in 10 cases. The diameters of nevi were from 8 to 12 mm (mean, 9.75 mm); no alar cartilage was invaded. Hair growth was seen in 14 cases. The duration of nasal nevi was from 3 years to 49 years (mean, 9.8 years). There were 9 recurrent patients who received laser therapy before surgery. The defects sizes after excision were from 10 mm×10 mm to 14 mm×14 mm. The bilobed flaps were used for one-stage reconstruction, which sizes were from 11 mm×10 mm to 15 mm×14 mm and from 10 mm×10 mm to 15 mm×14 mm. Results All the incisions healed by first intention, and the flaps survived. No complication of intracranial hemorrhage or subdural hemorrhage occurred. The patients were followed up 6 months to 5 years (mean, 18 months). The appearance of nasal tip and nasolabial fold was satisfactory, and no recurrence was found during follow-up. Conclusion One-stage bilobed flap reconstruction for nasal tip defects after giant nevus resection is one of the effective, safe, and aesthetic surgery methods.

Citation： LIZhengyong, PUYi, CENYing, WUJunliang, ZHANGZhenyu. TREATMENT OBSERVATION OF NASAL TIP DEFECTS RECONSTRUCTED BY BILOBED FLAPS AFTER GAINT NEVI EXCISION. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(11): 1373-1375. doi: 10.7507/1002-1892.20160281 Copy

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3.	Menick FJ. Artistry in aesthetic surgery. Aesthetic perception and the subunit principle. Clin Plast Surg, 1987, 14(4): 723-735.
4.	Yong JS, Christophel JJ, Park SS. Repair of intermediate-size nasal defects: a working algorithm. JAMA Otolaryngol Head Neck Surg, 2014, 140(11): 1027-1033.
5.	Maher IA, Lavigne K. Use of the standing cone allows for subunit repair of a large composite cheek and nose defect. Dermatol Surg, 2014, 40(11): 1255-1258.
6.	邢新, 薛春雨, 李军辉, 等.鼻部皮肤肿瘤切除后的创面修复.中国修复重建外科杂志, 2007, 21(7): 714-717.
7.	Meirson DH. Nasal anatomy and reconstruction. Dermatol Clin, 1998, 16(1): 91-108.
8.	Park SS. Reconstruction of nasal defects larger than 1.5 centimeters in diameter. Laryngoscope, 2000, 110(8): 1241-1250.
9.	Lohuis PJ, Godefroy WP, Baker SR, et al. Transposition flaps in nasal reconstruction. Facial Plast Surg Clin North Am, 2011, 19(1): 85-106.
10.	王亚辉, 黄勇, 邢新.双叶皮瓣在鼻部皮肤软组织缺损修复中的应用.中国美容整形外科杂志, 2008, 19(1): 3-5.
11.	Fujiwara M. One-stage reconstruction of an alar defect using a bilobed nasollabial-nasal tip flap based on the aesthetic subunits in Orientals: case report. Aesthetic Plast Surg, 2004, 28(1): 13-16.
12.	Cook JL. A review of the bilobed flap's design with particular emphasis on the minimization of alar displacement. Dermatol Surg, 2000, 26(4): 354-362.
13.	Belmahi A, EL Mazouz S, Gharib NE, et al. The bilobed flap: a very efficient method in aesthetic reconstruction of small skin defects at the alar and tip regions of the nose. Ann Chir Plast Esthet, 2003, 48(4): 211-215.
14.	Baker SR. Regional flaps in facial reconstruction. Otolaryngol Clin North Am, 1990, 23(5): 925-946.
15.	李华, 邵雁, 叶学红, 等.随意微小皮瓣在颜面部缺损的合理应用.中华整形外科杂志, 2005, 21(5): 391-392.
16.	严明忠, 钟广斌.面部整形中局部皮瓣的应用.临床医学美容杂志, 1999, 5(1): 14-15.
17.	吴燕梅, 朱华锋, 王健.局部皮瓣在面部整形修复中的应用.中华全科医学, 2009, 7(11): 1214-1215.

1. 王炜.整形外科学.杭州:浙江科学技术出版社: 103-127, 1045, 1051-1052.
2. Burget GC, Menick FJ. The subunit principle in nasal reconstruction. Plast Reconstr Surg, 1985, 76(2): 239-247.
3. Menick FJ. Artistry in aesthetic surgery. Aesthetic perception and the subunit principle. Clin Plast Surg, 1987, 14(4): 723-735.
4. Yong JS, Christophel JJ, Park SS. Repair of intermediate-size nasal defects: a working algorithm. JAMA Otolaryngol Head Neck Surg, 2014, 140(11): 1027-1033.
5. Maher IA, Lavigne K. Use of the standing cone allows for subunit repair of a large composite cheek and nose defect. Dermatol Surg, 2014, 40(11): 1255-1258.
6. 邢新, 薛春雨, 李军辉, 等.鼻部皮肤肿瘤切除后的创面修复.中国修复重建外科杂志, 2007, 21(7): 714-717.
7. Meirson DH. Nasal anatomy and reconstruction. Dermatol Clin, 1998, 16(1): 91-108.
8. Park SS. Reconstruction of nasal defects larger than 1.5 centimeters in diameter. Laryngoscope, 2000, 110(8): 1241-1250.
9. Lohuis PJ, Godefroy WP, Baker SR, et al. Transposition flaps in nasal reconstruction. Facial Plast Surg Clin North Am, 2011, 19(1): 85-106.
10. 王亚辉, 黄勇, 邢新.双叶皮瓣在鼻部皮肤软组织缺损修复中的应用.中国美容整形外科杂志, 2008, 19(1): 3-5.
11. Fujiwara M. One-stage reconstruction of an alar defect using a bilobed nasollabial-nasal tip flap based on the aesthetic subunits in Orientals: case report. Aesthetic Plast Surg, 2004, 28(1): 13-16.
12. Cook JL. A review of the bilobed flap's design with particular emphasis on the minimization of alar displacement. Dermatol Surg, 2000, 26(4): 354-362.
13. Belmahi A, EL Mazouz S, Gharib NE, et al. The bilobed flap: a very efficient method in aesthetic reconstruction of small skin defects at the alar and tip regions of the nose. Ann Chir Plast Esthet, 2003, 48(4): 211-215.
14. Baker SR. Regional flaps in facial reconstruction. Otolaryngol Clin North Am, 1990, 23(5): 925-946.
15. 李华, 邵雁, 叶学红, 等.随意微小皮瓣在颜面部缺损的合理应用.中华整形外科杂志, 2005, 21(5): 391-392.
16. 严明忠, 钟广斌.面部整形中局部皮瓣的应用.临床医学美容杂志, 1999, 5(1): 14-15.
17. 吴燕梅, 朱华锋, 王健.局部皮瓣在面部整形修复中的应用.中华全科医学, 2009, 7(11): 1214-1215.

Chinese Journal of Reparative and Reconstructive Surgery

TREATMENT OBSERVATION OF NASAL TIP DEFECTS RECONSTRUCTED BY BILOBED FLAPS AFTER GAINT NEVI EXCISION

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