The highly contoured nature of the nose and the abundant free margin makes it especially
difficult to reconstruct. In this report, we describe the use of a new helical rim
free flap technique for the reconstruction of full-thickness nasal alar defects via
supermicrosurgery. Briefly, after a wide excision with a margin of 0.7 cm, an alar
defect with a size of 1×1×0.5cm was obtained, which included the full thickness of
the skin, mucosa, and lower lateral cartilage. Vessel dissection was performed in
a straightforward manner, starting from the incision margin for flap harvest, without
any further dissection for reach the greater trunk of the superficial temporal artery.
The flap was inset in order to match the contour of the contralateral ala. We closed
the donor site via rotation and advancement. No donor site morbidity was observed,
despite the presence of a small scar that could easily be covered with hair. The alar
contour was satisfactory, and the patient was satisfied with the results. The supermicrosurgical
technique did not require further dissection to identify the vessels for anastomosis,
leading to better cosmetic outcomes and a reduced operating time.
Keywords
Nose - Free tissue flaps - Carcinoma, squamous cell
