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Hwang et al. Plast Aesthet Res 2016;3:291-5 Plastic and
DOI: 10.20517/2347-9264.2016.70
Aesthetic Research

www.parjournal.net
Original Article Open Access

Medially based de-epithelialized flap

for nasal base narrowing and nostril sill

augmentation in a cleft lip nasal deformity

Kun Hwang , Jong Hwan Choi , Hun Kim , Dae Joong Kim 3
1
1
2
1 Department of Plastic Surgery, Inha University School of Medicine, Incheon 400-711, South Korea.
2 Department of Plastic Surgery, Inha University Hospital, Incheon 400-711, South Korea.
3 Department of Anatomy, Inha University School of Medicine, Incheon 400-711, South Korea.
Correspondence to: Dr. Kun Hwang, Department of Plastic Surgery, Inha University School of Medicine, 27 Inhang-ro, Jung-gu, Incheon 400-711,
South Korea. E-mail: jokerhg@inha.ac.kr
How to cite this article: Hwang K, Choi JH, Kim H, Kim DJ. Medially based de-epithelialized flap for nasal base narrowing and nostril sill
augmentation in a cleft lip nasal deformity. Plast Aesthet Res 2016;3:291-5.

Dr. Kun Hwang is currently a Fellowship Professor, Department of Plastic Surgery, Inha University School of Medicine
and Inha University Hospital. More information could be found at: http://orcid.org/0000-0002-1994-2538.

ABSTRACT

Article history: Aim: The authors observed the nostril floor in a gross cadaver specimen histologically and
Received: 22-08-2016 innovated a medially based de-epithelialized flap for nasal base narrowing and nostril sill
Accepted: 05-09-2016 augmentation. Methods: In cadaver, fully thick section was taken from the nostril sill at
Published: 20-09-2016 the midpoint of the columella base and ala base, and stained with Masson-Trichrome. In
eight patients, circumferential incision along the nostril sill and alar base freed the alar base
from the upper lip. At the columellar base, fresh epithelium was shaved on the medial side
Key words: of the incision line. The widened scar on the upper lip was excised. The de-epithelialized
Cleft lip, tip of the columellar base was pulled under the medial tip of the alar base flap and sutured
nose deformities, tightly. Four anthropometric distances were measured preoperatively and postoperatively.
acquired, Results: Histologically the nostril sill was composed of thickened dermis. Just below the
surgical flaps, dermis, the depressor septi nasi muscle ran obliquely, augmenting the nostril sill. The
dermis nostril floor width, alar distance, and alar curvature distance decreased on the cleft side
after the operation. Conclusion: A medially based de-epithelialized flap narrows the alar
base and augments the nostril sill simultaneously, since the de-epithelialized part of the
excess skin augments the depressed nostril sill.

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