Nasal alar reconstruction: A critical analysis using melolabial island andparamedian forehead flaps

Objectives: To qualitatively and quantitatively describe aesthetic and func tional outcomes following Mobs ablative surgery involving the alar subunit, using a paramedian or subcutaneous melolabial island nap. Study Design: Re trospective review. Methods: A single surgeon's results in 38 consecutive p atients were analyzed. Objective measures (alar rim thickness, donor scar w idth and length), subjective assessment (seven aesthetic parameters) by thr ee academic otolaryngologists, and patient satisfaction questionnaires were evaluated. Student t test was used to ascertain statistically significant differences between reconstructive groups. Results: Questionnaire results d emonstrate a significant (P = .026) difference in donor site rating favorin g melolabial group responses. Objective scar measurements and subjective ra tings of textural quality and alar notching also favored melolabial reconst ructions. Conclusions: More favorable aesthetic and functional outcomes are seen with single subunit cutaneous alar defects reconstructed with the mel olabial island flap than with deep composite or extensive unilateral nasal defects reconstructed with the paramedian forehead flap.