COMBINATION OF AN ISLAND ADVANCEMENT FLAP AND A COMPOSITE GRAFT FOR RECONSTRUCTION OF THE NASOLABIAL DEFECT

BACKGROUND. The alar region is one of the most difficult areas of the face to reconstruct. Up until now, various methods have been demonstra ted for achieving the best possible results in terms of cosmetic appea rance and function. This report deals with a combination of a random p attern flap and a free composite graft, carried out in two stages. OBJ ECTIVE. In order to reconstruct the alar region, an island advancement flap as well as a composite graft from the contralateral ear were use d. METHODS. The defect in the cheek-upper lip region was closed using an island advancement flap. In a second operation 2 weeks later, the r econstruction of the alar region was attempted using a composite graft from the right ear. RESULTS. The reconstruction of the contour of the wing of the nose succeeded in a satisfactory manner. There are no fun ctional restrictions on nose breathing. CONCLUSIONS. The combination o f an island advancement flap with a composite graft from the ear for t he reconstruction of the alar region is essentially a less invasive op eration that can be carried out tinder local anaesthesia and that repr esents an addition to the previously stated methods. (C) 1997 by the A merican Society for Dermatologic Surgery, Inc.