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Reconstruction of nasal defects using modified composite grafts

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1 Reconstruction of nasal defects using modified composite grafts
R.Y. Chandawarkar, A.L. Cervino, M.D. Wells  British Journal of Plastic Surgery  Volume 56, Issue 1, Pages (January 2003) DOI: /S (03)

2 Figure 1 A. Anatomic subunits treated using MCG. B. Areas of thin skin on the lower margin as well as the dorsum of the nose. C. The plane of dissection of the pocket depends upon the location of the nasal defect and its specific anatomy. Shaded areas and arrows show the possible directions in which the dissection pocket can be created. D. Defects in the soft triangle are dissected to create a pocket in an oblique plane along the alar rim. British Journal of Plastic Surgery  , 26-32DOI: ( /S (03) )

3 Figure 2 A. Preoperative view of a patient with an alar rim and soft triangle. B. MCG is carefully measured. C. The potential pocket for inset is marked. D. The graft is debulked and de-epithelialised. E. The flap is inset into the defect. F. Postoperative view at 8 weeks. British Journal of Plastic Surgery  , 26-32DOI: ( /S (03) )

4 Figure 3 A. Defect following resection of a basal cell carcinoma at the lobular–collumellar junction. B. MCG with the extended de-epithelized dermal pedicle. C. The flap is inset into the defect. D. Postoperative view at 6 months. British Journal of Plastic Surgery  , 26-32DOI: ( /S (03) )

5 Figure 4 A. Preoperative appearance following an incisional biopsy of lesion (performed elsewhere). B. Defect following resection of a basal cell carcinoma at the alar rim. C. The composite graft includes the helical root. The arrow indicates the extension of the incision along the preauricular crease. D. This incision allows upward mobilisation and primary closure of the donor-site defect. E. The flap is inset into the defect. F. Appearance of the reconstructed site 10 months postoperatively. G. The donor-site scar. British Journal of Plastic Surgery  , 26-32DOI: ( /S (03) )

6 Figure 5 A. Preoperative view. B. Defect following resection of a basal cell carcinoma at the soft triangle. C. The composite graft includes the helical root. D. Anterior and E. oblique views of the reconstructed site 12 months postoperatively. British Journal of Plastic Surgery  , 26-32DOI: ( /S (03) )

7 Figure 6 A. Preoperative view. B. Defect following resection of a basal cell carcinoma at the soft triangle. C. The MCG is designed with a biaxial dermal pedicle. D. MCG prior to inset; note the bilateral dermal pedicles. E. The graft is inset into the defect. F. Lateral and G. anterior views 10 months postoperatively. British Journal of Plastic Surgery  , 26-32DOI: ( /S (03) )


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