Non melanoma skin cancers are the most frequent malignant skin tumours and in over 25% of cases affect the nose. Following excision, the reconstruction can be challenging. The nasal complex has adjacent concave and convex surfaces, minimal laxity and nasal tip area has sebaceous glands. Reconstruction aims to preserve the anatomical units, nasal functions and also an aesthetic final outcome. Usual reconstructions for the nasal dorsum and tip are the bilobed flap, Zitelli’s bilobed flap, nasolabial flap, modified Nasalis flap and Riegers flap. For larger defects a forehead flap or island pedicle flap can be used. This paper from Italy describes a modification of the cresentic flap to reconstruct defects of the nose on the dorsum. Twenty-four patients had oncologic surgery and the defects were repaired with this flap. Eighteen cases had a unilateral flap and six had bilateral flaps. Only three patients had a small area of dehiscence. All patients were satisfied with the outcomes. This is a good paper and any technique that helps reconstruct the tip, supra tip and nasal dorsum is a welcome addition. In addition the scars are in the perialar area with good aesthetics. The technique is not well described but there are some photographs that help understand the flap design. Overall this is a useful paper and worth reading for anyone with a facial surgical dermatology interest.
A modification of the crescentic flap for nasal skin reconstruction
Reviewed by Sunil K Bhatia
Crescentic flap for the reconstruction of the nose after skin cancer resection.
