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August 1994

A Variation of Composite Grafting for Reconstruction of Full-Thickness Nasal Alar Defects

Author Affiliations

University of California—Davis; University of California—San Francisco

Arch Dermatol. 1994;130(8):978-980. doi:10.1001/archderm.1994.01690080042004

REPORT OF A CASE  A 72-year-old man presented with a biopsy-proven basal cell carcinoma on the right alar rim. Following resection of the tumor, the patient had a 0.9×0.4-cm full-thickness defect of the alar rim (Figure 1).

THERAPEUTIC CHALLENGE  Removing a malignancy from the alar rim of the nose often results in destruction of the skin, the underlying cartilage, and nasal mucosal lining. These full-thickness defects are difficult to repair because of the need to replace structural support, skin, and nasal lining.

SOLUTION  This skin and fat variation of a composite graft uses a rectangular-shaped skin and fat graft from the inner upper arm, supraclavicular area, or the earlobe. The graft is removed from the donor site and minimally defatted to approximate the contour of the alar rim.The graft is sutured into the mucosal surface of the defect with 6-0 fast-absorbing chromic gut with the epidermis forming the ''new''

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