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February 1994

The Labial-Ala Transposition Flap

Author Affiliations

Baylor College of Medicine, Houston, Tex

Arch Dermatol. 1994;130(2):162-164. doi:10.1001/archderm.1994.01690020028005

REPORT OF A CASE  A 53-year-old white woman presented with a primary nodular basal cell carcinoma on the right nasal ala adjacent to the nasolabial fold (Figure 1). The suspected clinical extent of the tumor was 0.5×0.4 cm.Mohs micrographic surgery was performed. The resulting surgical defect measured 0.8×0.6 cm with the deep margin involving the subcutaneous fat. The defect extended to the melolabial junction but spared the free margin of the nasal rim (Figure 2).

THERAPEUTIC CHALLENGE  The patient had a surgical defect of the nasal ala involving the melolabial junction but sparing the free margin of the nasal rim. Healing by second intention was considered, but distortion of the free edge of the nasal ala would probably occur. A full-thickness skin graft was a viable option, but a flap would give better skin texture match. Various flap designs were considered. Our challenge was to design an inferiorly

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