Repair of full-thickness alar defects.

Background: A basal cell carcinoma can invade the cartilage in the nasal ala and can reach the nasal vestibule skin. A full-thickness reconstruction of the nasal ala is required to repair the tissue damage after tumor removal. We combined an auricular composite graft with a nasolabial flap to repair the defects in the nasal ala.
Methods: Eleven patients with full-thickness infiltration of the nasal ala by basal cell carcinoma were included in the study. The outer defect area after tumor removal ranged from 1.5 × 2.0 to 2.0 × 2.5 cm(2). Skin-cartilage composite grafts 1.5 × 1.5 to 1.5 × 2.0 cm(2) in size were harvested from the helix at the top of the ear. The composite graft was used as a support scaffold to reconstruct the defects. A nasolabial flap was used to cover the cartilage.
Results: All cases were treated successfully. No flap necrosis, skin color changes, or blistering occurred. The shape of the flap was stable, and the skin color was consistent with that of the surrounding tissue. The reconstructed nasal ala was symmetrical.
Conclusions: Combining an auricular composite graft with a nasolabial flap can repair defects up to 2.0 × 2.5 cm(2) in size. The reconstructed nasal ala matches the original skin color and maintains the appropriate shape.
(© 2012 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.)