ObjectiveTo discuss a reliable and aesthetic surgery method for the reconstruction of large defects on the top of nose after giant nevi resection. MethodsBetween 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. ResultsAll 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. ConclusionOne-stage bilobed flap reconstruction for nasal tip defects after giant nevus resection is one of the effective, safe, and aesthetic surgery methods.
ObjectiveTo evaluate the effectiveness of an arc-shaped frontalis aponeurosis flap for the treatment of moderate to severe blepharoptosis. MethodBetween January 2011 and December 2014, 80 cases (140 eyes) of moderate to severe blepharoptosis were treated, including 31 males and 49 females with a median age of 16 years (range, 6-45 years). One eye was involved in 20 cases and both eyes in 60 cases. Upper eyelid ptosis degree ranged from 3 to 6 mm (average, 5 mm) when looking at the front horizontally. Fifty-one patients had underwent plastic surgery, and the first operation was performed in others. The arc-shaped frontalis aponeurosis flap was created by incision of upper and middle edge of the eyebrow, then it was retracted to the upper eyelid aponeurosis and was fixed in a slight over-correction position. ResultsThe operation was completed smoothly. The intraoperative blood loss was 5-10 mL (mean, 7 mL). Mild swelling of incision was observed after operation, and disappeared at 3-5 days after operation. Primary healing of incision was obtained, with no complications of infection and flap necrosis. The follow-up duration was 1-3 years (mean, 1.5 years). Seventy-nine cases could close upper eyelid completely and the function of upper eyelid was satisfactory within 3 months. One patient could not close upper eyelid completely after 6 months, and mild keratitis occurred, which was cured by anchyloblepharon. ConclusionsThe arc-shaped frontalis aponeurosis flap can be regarded as a minimally invasive procedure for the treatment of congenital moderate to severe blepharoptosis, it was safe, reliable, and easy-to-grasp.