THE STAGED CHEEK-TO-NOSE INTERPOLATION FLAP FOR RECONSTRUCTION OF THENASAL ALAR RIM LOBULE/

Background: A deep defect of the nasal alar rim or lobule may represen t a unique and difficult challenge because of the lax free margin and structural support supplied by the alar rim and lobule. Traditional cl osure strategies, including granulation, full thickness skin grafting, or nasolabial transposition flaps may result in unsatisfactory cosmet ic and functional outcomes. Objective: This article describes our expe rience with the staged cheek-to-nose interpolation flap for repairing deep skin cancer excision defects of the nasal alar rim and lobule. Me thods: The staged cheek-to-nose interpolation flap was used immediatel y after Mohs micrographic surgery to repair 18 deep nasal alar rim/lob ule defects. In 13 patients, a free cartilage graft was used to restor e structural support. Results: The cosmetic and functional outcomes of each repair were judged from good to excellent by patient and surgeon . No cases of infection or flap necrosis occurred. To enhance the cosm etic outcome, three patients underwent spot dermabrasion within 2 mont hs after flap detachment. Conclusion: The staged cheek-to-nose interpo lation flap, with or without free cartilage grafts, consistently provi des good to excellent cosmetic and functional outcomes when performed on properly selected deep nasal alar rim/lobule defects.