Checkmark rotation flap for nasal tip reconstruction in Asian patients

Abstract

Background: Nasal tip reconstruction (NTR) of the Mohs defect is challenging, especially in Asians who have a relatively low nasal bridge and thin cartilages.

Objective: To evaluate the usefulness of a new flap design, the checkmark rotation flap (CRF), for NTR in Asians

Methods and materials: We retrospectively reviewed 31 cases of NTR. Among these, 15 cases underwent CRF, which uses skin from the columellar or infra-tip area with a checkmark v-shaped incision (CRF group). The remaining 16 cases underwent reconstruction with other flaps such as the bilobed or island pedicle flap (Others group).

Results: The average defect area was larger in the CRF than in the Others group (1.85 ± 1.01 cm² vs. 1.10 ± 0.72 cm², p = .0499), but the visual analog scale score was significantly higher in the CRF group (7.97 ± 1.36 vs. 6.25 ± 1.62, p = .0059). For complications, a depressed scar was observed in four cases (26.7%) in the CRF group; nine cases (56.3%) in the Others group presented with a depressed scar, hypertrophic scar, or scarring similar to a trap door deformity.

Conclusion: CRF may be a favorable option for the reconstruction of intermediate-sized nasal tip defects, providing good cosmetic outcomes.

Keywords:

• Mohs defect
• nasal tip reconstruction
• skin cancer

Acknowledgements

The authors thank MID (Medical Illustration & Design, Seoul, Korea) for helping with the design of the figures.

Disclosure statement

The authors have indicated no significant interest with commercial supporters.

Additional information

Funding

This work was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning [grant number 2013R1A2A2A04015894].