Cheek Flap

If a large defect of the nasal dorsum cannot be adequately covered with a midline Rieger flap (see Fig. 5.10), it may be necessary to perform a unilateral or bilateral cheek advancement (Fig. 5.12) with Burow's triangles in the nasolabial folds. A better scar is obtained by adding a Z-plasty on the nasal dorsum (Fig. 5.12a, b). The median forehead flap is also useful for this type of reconstruction (see p. 33, Fig. 5.15).

Nasolabial Flap

Fig. 5.11 Nasolabial flaps (Cameron 1975) used to reconstruct b A second nasolabial flap (right) is used for cover. a full-thickness defect. c Closure of all defects.

a One nasolabial flap (left side) is de-epithelialized in the sep-tal area to reconstruct the lining.

Fig. 5.11 Nasolabial flaps (Cameron 1975) used to reconstruct b A second nasolabial flap (right) is used for cover. a full-thickness defect. c Closure of all defects.

a One nasolabial flap (left side) is de-epithelialized in the sep-tal area to reconstruct the lining.

Square Triangle Flap Plastic Surgery
Fig. 5.12 Two cheek rotation flaps used to reconstruct a two-layer defect of the nasal dorsum (Cameron 1975). a The flap is raised, and two Burow's triangles are excised in the nasolabial fold. b All the wounds are closed. A dorsal Z-plasty can be added to place the scars in the RSTLs.

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