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Original Article Plastic and Aesthetic Research

A modified bilobed flap design for nasal

tip defects

Zhi-Guo Wang , Xiu-Juan Chen , Zhen-Yu Chen 1
2
1
1 Department of Burn and Plastic Surgery, Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong, China.
2 Department of Stomatology, Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong, China.
Address for correspondence: Dr. Zhen-Yu Chen, Department of Burn and Plastic Surgery, Affiliated Hospital of Qingdao University,
No.16 Jiangsu Road, Shinan District, Qingdao 266003, Shandong, China. E-mail: wzg_qd@126.com

ABSTRAC
Aim: The correction of nasal tip defects presents many challenges. Zitelli’s bilobed flap has been
widely used for such repairing defects, but may be complicated by interrupted scars on the nasal
dorsum. Our study evaluates the design principles, results, and advantages of a modified bilobed
flap for repairing nasal tip defects. Methods: The primary lobe was located between the defect
and the cheek, and the second lobe was located in the cheek. The width of the primary lobe
was equal to that of the primary defect. The length of the primary lobe was 10% longer than the
distance of the distal defect edge to the pivot point of the flap. The length of the second lobe was
30% longer than the distance of the distal defect edge to the pivot point of the flap. The width
of the second lobe was 90-100% of that of the primary lobe. The ability to close the defect under
minimal tension, the cosmetic appearance, and any complications were evaluated. Results: This
technique was performed in 34 cases; defect size ranged from 0.8 cm × 0.9 cm to 1.2 cm × 1.8 cm.
All defects were closed under minimal wound tension, all scars were inconspicuous, no obvious
complications occurred, and the aesthetic outcomes were considered favorable. Conclusion: The
modified bilobed flap can provide satisfying outcomes with lower morbidity and inconspicuous
scarring. It is simple and suitable for repairing small- to medium-sized defects in the nasal tip.

Key words:
Bilobed flap, nasal reconstruction, nasal tip defect

INTRODUCTION the nose and cheek, and review the advantages of this
technique’s use in nasal tip reconstruction.
Resection of benign lesions is a common cause of
nasal defects in young patients. The conventional METHODS
bilobed flap (Zitelli’s design) used for reconstruction
of defects of the lower third of the nose traditionally Our study comprised 34 patients who had defects of
utilizes skin from the mid dorsum and the sidewall the nasal tip. We conducted a retrospective review of
of the nose. However, the conspicuous scarring and all patients who had undergone defect reconstruction
[1]
loss of conformity in the cosmetic subunits of the nose
might be unacceptable to young patients, particularly with the modified bilobed flap by a single surgeon at
in individuals with darker skin tones. Herein, we the Department of Plastic Surgery, Affiliated Hospital
describe a modified bilobed flap that utilizes skin from of Medical College, Qingdao University, from July
Access this article online 2008 to July 2013. The review board of our Affiliated
Quick Response Code: Hospital approved this study and all patients involved
Website: in this article agreed to have their pictures published
www.parjournal.net
and signed the consent form. Outcome measures
included the ability to close the defect with minimal
DOI:
10.4103/2347-9264.135540 tension, cosmetic appearance, any complications, and
any need for further repair.

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