CC BY 4.0 · Arch Plast Surg
DOI: 10.1055/a-2337-2131
Idea and Innovation

A LIFEBOAT FOR FAILED NASAL RECONSTRUCTIONS: THE SUPRACLAVICULAR-SUBMENTAL SANDWICH FLAP

Michel Luciano Holger Toledano Vaena
1   Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil (Ringgold ID: RIN28130)
,
Kevin Sicalo
2   Plastic Surgery, Hospital Universitario Pedro Ernesto, Rio de Janeiro, Brazil (Ringgold ID: RIN199987)
,
Caterina Goulart Alessio
2   Plastic Surgery, Hospital Universitario Pedro Ernesto, Rio de Janeiro, Brazil (Ringgold ID: RIN199987)
,
Eduardo Pantoja Bastos
2   Plastic Surgery, Hospital Universitario Pedro Ernesto, Rio de Janeiro, Brazil (Ringgold ID: RIN199987)
› Author Affiliations

Many failures in total or subtotal nasal reconstructions result from an underestimation of the amount of skin required for an adequate result, especially for sufficient lining. Such planning errors usually lead to poor results, with exposure of structural grafts, infection, scar retraction, airway obstruction and finally loss of projection and shape of the reconstructed nose. Reconstruction options for cases in which previous attempts have failed are always limited, as well as in cases of trauma or burns affecting the soft tissues of the forehead and face. In such complex situations, one may employ free flaps or tissue expansion, but such resources may not be always available. We describe a technique indicated for salvage surgeries in patients whose previous nasal reconstruction have failed, allowing a generous amount of tissue transfer for the nasal region. The technique combines the use of supraclavicular and submental flaps, with simple execution, not requiring microsurgical skills or devices such as tissue expanders. Done in three stages, the described technique provides enough skin for a total nasal reconstruction. The final result is obtained after subsequent refinements, and the total number of procedures is equivalent to when more sophisticated techniques are employed, such as tissue expansion or microsurgery.



Publication History

Received: 19 September 2023

Accepted after revision: 30 May 2024

Accepted Manuscript online:
03 June 2024

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