The triplane aesthetic reconstruction of the alar unit after removal of advanced basal cell carcinomas. About 26 cases

• Published in: Annales de chirurgie plastique et esthétique 2022-02, Vol.67 (1), p.26-34
• Main Author: Belmahi, A
• Format: Article
• Language: fre
• Subjects: Aged; Carcinoma, Basal Cell - surgery; Esthetics; Humans; Middle Aged; Neoplasm Recurrence, Local; Nose - surgery; Nose Neoplasms - surgery; Rhinoplasty; Skin Neoplasms - surgery
• ISSN: 1768-319X
• DOI: 10.1016/j.anplas.2021.10.002

The aesthetic reconstruction of full thickness defects of the entire ala is difficult because of its complex tridimensional anatomy. The triplan reconstruction of this unit which includes: -a lining with a mucosal flap, -a sculptured cartilage framework imitating the anatomy of the opposite ala -and a skin coverage by an immediate defatted forehead flap, gives regularly a very good aesthetic results, superior to the ones obtained by other techniques. From may 2008 to December 2020, 26 patients aged between 49 and 78 years old have benefited from this triplan aesthetic reconstruction after an excision of evolved basal cell carcinomas interesting the ala unit. The defects resulting were located in the entire ala with slight extension to the adjacent units. In all cases, the lining was reconstructed by the BURGET'S homolateral septal mucosal flap. The shape of the ala was obtained by a precise sculpture of conqual cartilage, taking the opposite ala as the model. The cutaneous coverage was provided by a paramedian forehead flap tailored exactly to the defect's size and immediately defatted. With a mean follow up of 8 years, all the reconstructed ala were quasi symmetrical to the opposite ones with a very good shape of the new nostrils. No complications and no tumoral recurrence are reported. This triplan reconstruction of the entire ala's defects is really aesthetic and gives a natural look for the lower third of the nose.