The island flap described by Converse (1977), based on one or both trochlear arteries, is also useful for reconstructing defects in the nasal dorsum (Fig. 5.9). The bridge of skin between the island flap and the primary defect can be partially or completely divided if the flap shows livid discoloration due to excessive pressure on the pedicle.
Fig. 5.8a Outlining a superiorly or inferiorly based bilobed flap. b Closure of all defects. (Distortion of the lower eyelid should be avoided!)
- Fig. 5.9 Island flap based on the supratrochlear artery (Converse 1977). a The flap is outlined, and subcutaneous dissection is performed without vascular injury. b The bridge of skin between the flap and defect is undermined, and the island flap is pulled through. c Closure of all defects.
- Fig. 5.10 Trapezoidal V-Y advancement of Rieger (can also reach the nasal tip; see Fig. 5.14).
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Acne is a name that is famous in its own right, but for all of the wrong reasons. Most teenagers know, and dread, the very word, as it so prevalently wrecks havoc on their faces throughout their adolescent years.
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