Bilobed Flap
Bilobed Flap - Reconstruction of the Nose



  • Slide 1.  Preoperative Appearance of Basal Cell Carcinoma of the Nose
  • Slide 2.  Nasal Defect After Mohs Excision
  • Slide 3.  Surgical Plan - Outlining the FlapsEach lobe is at approximately a 45 degree angle and each is slightly smaller than the defect it fills. Note the defect of the last lobe is closed primarily and is placed at the junction between the cheek and naris. Depending upon where the defect is the lobes may vary between 45 to 60 degrees.
  • Slide 4. Flap ElevationThe lobes of the flap are cut and rotated into position.
  • Slide 5. Appearance After Operative Closure
  • Slide 6. Appearance Seven Days Post-Op
  • Slide 7. Appearance Seven Days Post-Op
  • Slide 8. Appearance four weeks Post-Op
  • Slide 9. Appearance four weeks Post-Op
Repair of a Nasal Defect From Excision of a Basal Cell Carcinoma Using a Bilobed Flap

This flap is a combination between a rotation advancement and nasal labial flap.  The flap is comprised of two lobes, each positioned at an angle of 45 to 60 degrees, which are rotated to fill corresponding defects.  Each lobe is slightly smaller than the defect it fills. The prominent "dog ear" and distortion of the nostrils, which can occur with a nasal labial flap are less likely to occur with a bilobed flap.  The bilobed flap is useful in reconstructing nasal alar defects of 1.5 cm or less. Keeping the angle of the lobes at 45 degrees minimizes tissue protrusions.  The final lobe should be positioned on the border of the facial aesthetic subunit, between the nose and the cheek. View Abstract  


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