[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 54.146.179.146. Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Citations 0
Practice Commentary
January 1999

Modification of the Subunit Principle

Author Affiliations

Section of Plastic and Reconstructive Surgery
The University of Chicago
2913 N Commonwealth Dr, Suite 400
Chicago, IL 60657-6224

 

Section of Plastic and Reconstructive Surgery
 The University of Chicago
 2913 N Commonwealth Dr, Suite 400
 Chicago, IL 60657-6224


Arch Facial Plast Surg. 1999;1(1):16-18. doi:10.1001/archfaci.1.1.16

SHUMRICK ET AL have written a good article; it introduces an important method for analyzing aesthetic results. But there is a flaw at its core. The subunit principle is appealing, but other variables are far more important to the aesthetic success of nasal reconstruction: (1) thinning the flap correctly, (2) matching flap edges to the recipient site, (3) giving the flap a normal or beautiful contour with a shapely subcutaneous cartilage framework, and (4) bracing the flap's marginal scars with thin platforms of cartilage, especially along the alar margin. These are the things that determine success far more than the relatively subtle effect of the subunit principle. If these techniques are applied artistically, a normal nose can result even when the subunits are entirely ignored (Figure 1). Shumrick et al have wrongly attributed the entire success or failure of their cases to their use of the subunit priniple.

First Page Preview View Large
First page PDF preview
First page PDF preview
×