The nasal sidewall rotation flap: a workhorse flap for small defects of the distal nose.

BACKGROUND: Skin cancers of the nasal tip present a challenge for the dermatologic surgeon. The bilobed flap has been widely used as the "workhorse" flap for such defects but requires meticulous design and may be complicated by a tendency toward pin-cushioning.

OBJECTIVE: To describe the use of the nasal sidewall rotation (NSR) flap for reconstructing defects on the nasal tip.

METHODS: A retrospective analysis of the Mohs micrographic surgery database over a 4-year period was performed. All cases in which the NSR flap was used were identified. Defect location and size and any postoperative complications were noted. All patients were reviewed at the time of suture removal and at 6 weeks.

RESULTS: There were 65 cases (19 men and 46 women). Age ranged from 39 to 86 (mean 60.5, median 59). Defect size varied from 0.4 to 2.0 cm in diameter, with 63% measuring 1.0 to 1.4 cm. Good to excellent results were seen in all patients, and postoperative complications were uncommon and minor. CONCLUSION The NSR flap is a versatile and useful alternative for reconstructing surgical defects of the nasal tip. The authors have indicated no significant interest with commercial supporters.