Bilobe flap with auricular cartilage graft for nasal alar reconstruction

Abstract Objective To report outcomes for reconstruction of the nasal ala using a bilobe flap in combination with an auricular cartilage graft. Study design Case series with chart review. Setting Academic tertiary care medical center. Subjects and methods Data were obtained by a retrospective review of patients treated by a single surgeon (SPM) from January 2013 to December 2014. Patients were included who underwent reconstruction of the nasal ala using a bilobe flap in combination with an auricular cartilage graft. Clinical notes and postoperative photographs were reviewed to evaluate post-operative outcomes including flap viability, presence of iatrogenic lateral nasal wall insufficiency, alar retraction, and patient and surgeon reported satisfaction with aesthetic outcome. Results A total of 7 patients (3 male, 4 female) met inclusion criteria. Patient age ranged from 34 to 71 years (mean: 55 years). Follow-up time ranged from 1 to 12 months (mean: 6.3 months). All defects were located within 5 mm of the alar margin. Defect size ranged from 6 to 15 mm in largest diameter (average 11 mm). There were no incidences of flap loss, alar retraction, or iatrogenic lateral wall insufficiency, and all patients had results deemed aesthetically satisfactory by both the patient and surgeon. Conclusions Defects of the nasal ala can be successfully reconstructed using a bilobe flap in combination with an auricular cartilage graft with excellent aesthetic and functional outcomes.