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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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Each 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.
The lobes of the flap are cut and rotated into position. 
