The nasolabial flap is a useful reconstructive technique for the repair of defects on the nose. An improved technique used in 32 patients is presented, which allows use of this procedure as a single-stage rather than the more commonly seen two-stage procedure. The alterations include the following: (1) the excision of a Burow's triangle superior edge of the defect toward the inner canthus; (2) the use of a periosteal or suspension suture to minimize tenting across the concave junction of the nose and cheek; (3) wide undermining of the skin surrounding the defect to create a stabilizing platelike scar; (4) significant thinning of the donor flap; and (5) adjust the size of the flap to recreate the original preincisional skin tension on the flap after suturing. None of the 32 patients presented required a second-stage procedure to correct trapdoor defects or to recreate natural folds or creases.
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