Abstract
The double-half bilobe flap was initially described by the senior author (S.P.M.)
in 2012 to address defects of the midline nasal tip typically after ablative carcinoma
resection. It is a unique reconstructive option for the nasal tip, as it does not
depend on a unilateral tissue advancement vector, instead using bilateral and opposing
vectors to maintain symmetry. In this retrospective cohort series, we evaluated patient-
and physician-derived outcomes and baseline characteristics from a group of 17 patients
that underwent reconstruction with the double-half bilobe flap. A control group of
65 patients that underwent traditional bilobe reconstruction for defects of one nasal
subunit (tip, side wall, or dorsum) was used for comparison. Outcome measures included
infection, symmetry, pin-cushioning, scarring, reoperation, and adjunct procedures.
Also, patient satisfaction was evaluated by using frequency of follow-up as a surrogate
for patient discontentment with aesthetic outcome. The double-half bilobe flap provides
improved symmetry and otherwise similar overall outcomes compared with the traditional
bilobe flap, and should be considered as a primary option for the reconstruction of
midline nasal tip defects less than 15 mm in diameter.
Keywords
bilobe flap - skin cancer - reconstruction - local flap
