From the Research
The correct answer is b. A bilobed flap can be used to reconstruct full thickness alar defects. This specialized flap consists of two adjacent lobes or segments of tissue that are designed to rotate into a defect. The bilobed flap is particularly useful for nasal reconstruction, especially for defects of the nasal ala, where its design allows for the transfer of tissue from areas of relative laxity to areas with limited tissue mobility. While both lobes of the flap do rotate, they typically rotate between 45-60 degrees each (not 90 degrees for both) 1. The flap provides a single layer of tissue rather than two layers, so it doesn't inherently provide better cosmesis through layering. One of the main advantages of the bilobed flap is that it uses adjacent tissue with similar skin texture and color for reconstruction, which helps achieve good cosmetic outcomes, but this is not unique to bilobed flaps as other local flaps also use similar tissue.
Some key points to consider when using a bilobed flap include:
- The flap is useful for reconstructing small to medium-sized defects of the nasal ala and tip 2
- The design of the flap should be based on the aesthetic subunits of the nose, taking into account the texture, shape, and free margin of the ala 3
- The flap can be used in a single-stage procedure to reconstruct full-thickness defects of the ala, including the internal nasal lining 4
- Complications such as pincushioning and poor aesthetic outcomes can be minimized by adequately thinning the transposition flap and using a careful surgical technique 1
Overall, the bilobed flap is a versatile and effective option for reconstructing defects of the nasal ala and tip, offering good cosmetic and functional outcomes when used properly.