Anteriorly Based Alar Rotation Weerda 1984

Our technique differs from Denonvilliers' in that we use a flap based anteriorly on the nasal tip to bring down the alar rim. This allows us to place the Z-plasty more in the area of the nasolabial fold and

Anterior Alar Rim
Fig. 5.33 Sliding flaps for reconstructing defects behind the ala (a, b) or in the lateral nasal wall (c, d). These flaps are of variable size and may be transferred on a subcutaneous pedicle (see Fig. 3.12).
Nasal Alar Rim

Fig. 5.34 Z-plasty of Denonvilliers and Joseph (1931). a Laterally and medially based flaps (1, 2) are transposed to bring down the alar rim. b Closure of all defects.

Fig. 5.34 Z-plasty of Denonvilliers and Joseph (1931). a Laterally and medially based flaps (1, 2) are transposed to bring down the alar rim. b Closure of all defects.

cheek, where the skin is generally more mobile. The somewhat thicker cheek skin must be adequately thinned, and secondary refinement of the alar rim may be necessary at a later time.

Anterior Alar Rim
Fig. 5.35 a Anteriorly based alar rotation of Weerda (1984). b All defects are covered with a Z-plasty.

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