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Commentary |

Triple-Flap Technique for Reconstruction of Large Nasal Defects

Frederick J. Menick, MD
Arch Facial Plast Surg. 2001;3(1):22-23. doi:.
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WILD and Hybarger report their experience in 10 patients with reconstruction of 3½- to 5-cm nasal defects of the tip, dorsum, sidewall, and ala. They use an ipsilateral dorsal nasal flap and a myelolabial flap for the primary defect, and close the secondary defect (in the opposite nasofacial groove) with a contralateral cheek flap. The triple-flap technique is recommended for central and distal nasal losses, including unilateral alar or full-thickness defects of less than 5 cm, in patients who are not candidates for a forehead flap. Its proposed advantages (compared with a forehead flap) are a better skin match, a single operative stage, and less morbidity. The technique is illustrated by 2 clinical cases with good results. Included in the article is a description of a cadaver head that had been injected with dye to identify perforating vessels of the transverse facial artery and dorsal nasal artery, which supply the myelolabial flap and dorsal nasal flap, respectively, and to relate them to fixed facial landmarks to facilitate safe pedicle dissection.

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