Nasal defects commonly are a result of removal of skin lesions. Cosmetic outcomes of local flap reconstructions are commonly accepted to be superior in comparison to skin grafts. However, local flap reconstructions require more adjunctive procedures than single-stage operations based on a skin graft.
The authors hypothesised that in selected cases, skin grafts can provide aesthetic outcomes equal to those of local flaps and with fewer adjunctive procedures. A retrospective review was performed, analysing a total of 103 patients’ postoperative photographs (39 underwent skin graft reconstruction, 64 had reconstruction by local flap). Four independent raters, blinded to the reconstruction technique, used a visual analogue scale (VAS) to grade the surgical outcomes. Two raters were facial plastic surgical fellows and two raters had no medical training. The mean VAS score for the skin graft group was 2.18 (median, 2.50), while the mean score for the flap group was 2.12 (median, 2.00). The number for postoperative interventions was significantly higher after local flap procedures (including triamcinolone acetonide injection or dermabrasio). Sapthavee and co-workers results are contradictory to findings of previous studies, which suggest the best cosmetic results are achieved by local flaps. The authors not only highlight a valuable and reliable alternative for reconstruction of nasal defects, they also present details of their surgical procedures, which improve the outcome of skin grafts.