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In Reply.—We totally agree with Dr Peled that the rich blood supply makes the dorsal flap extremely successful. In our hands, the cosmetic results have generally been good. Obviously, there is a place for skin grafting in the repair of facial defects, but it is our tendency to use local flaps whenever possible because, we believe, they give superior cosmetic results in relationship to skin texture, color, and camouflage of the incision lines.
It would seem, from Dr Peled's letter, that he uses the dorsal nasal flap in a two-stage fashion. We routinely use the dorsal nasal flap as a one-stage procedure, which is one of its major advantages. The patients described in our most recent article were selected only because they demonstrated that the dorsal nasal flap can be repeated on the ipsilateral and contralateral sides of the nose (should it be needed a second time). As to
BRAY DA, EICHEL BS, KAPLAN HJ. The Dorsal Nasal Flap-Reply. Arch Otolaryngol. 1982;108(10):671. doi:10.1001/archotol.1982.00790580065023
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