Skin Cancer Repair on the Nose
Skin Cancer Repair on the nose can be a very challenging problem to repair. Basal Cell Carcinoma and Squamous Cell Carcinoma are found very commonly on the face for patients in Los Angeles. These non-melanoma types of skin cancer are particularly common on the nose. Reconstructing defects following removal of skin cancer from the nose is a particularly difficult surgical problem. When a tumor destroys a portion of the nasal ala (wing), a common repair technique is to use a naso-labial flap.
The videos below demonstrate the technique that Dr. Brenner uses to repair such defects. This patient was left with a large area of missing tissue along the left nasal ala. This was reconstructed in two stages with a nasolabial flap. During the first stage nasal skin cancer repair, a template was made of the normal side of the nose and transposed to the affected side. A subunit technique was used, and the after marking the nasal ala, the unaffected remaining portion of the subunit was removed entirely. A piece of ear cartilage was then removed from behind the left ear in order to provide structure to this portion of the nose. Then a naso-labial flap was designed and dissected. The flap is then thinned out and sewn into place along three sides. The fourth side is left attached to the original donor site and allowed to heal for about three weeks.
Stage 1 Skin Cancer Repair; Nasolabial Flap and Ear Cartilage Graft:
After three weeks of healing, the second stage of the nasal skin cancer repair is performed. During the second stage, the flap is divided, contoured to look like the structure that it is replacing and then inset with sutures. The remaining portion of the cheek is also contoured during this second stage operation. Occasionally, patients will return for a final third contouring procedure. This is usually done three to six months later.
Stage 2 Skin Cancer Repair; Division and Inset of Flap.