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ABSTRACT: We devised a new method to repair the depression of the nasal floor and inferolateral displacement of the alar base and to reconstruct the philtrum in the secondary repair of unilateral cleft lip. Depression of the nasal floor and inferolateral displacement of the alar base were corrected by advancing a lump of the levator labii superioris, the levator labii superioris alaeque nasi, and the upper part of the superficial orbicularis oris muscles to the anterior nasal spine. When the depression of the nasal floor was too severe to repair using these muscles only, a cranially-based de-epithelialised flap of the scar region on the upper lip was inserted under the nasal floor. The lower, greater part of the superficial orbicularis oris muscle was dissected to the nasolabial fold, brought towards the midline, and laid on the surface of the same muscle on the medial side to be sutured. When the depression of the nasal floor was not severe, the lower, greater part of the superficial orbicularis oris muscle was passed through a tunnel pierced beneath the de-epithelialised scar tissue and sutured to the corresponding components on the medial side to reinforce the philtral ridge. In both cases, if the deep orbicularis oris muscle in the vermilion had been interrupted, it was reconstructed by end-to-end anastomosis. Operative results were evaluated in 76 patients using photographs taken preoperatively and postoperatively. Elevation of the nasal floor and correction of the alar base were achieved in most patients, while reconstruction of the philtrum was achieved in cases in which the skin tension at the suture line was weak.
Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery 07/2000; 34(2):121-9. · 0.94 Impact Factor
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ABSTRACT: Two patients with nasal skin defects resulting from excision of rhinophyma and multiple angiofibromas were treated with artificial dermis followed by full-thickness skin grafts taken from the postauricular region. The secondary skin grafts took completely in both patients, and the postoperative results were excellent. Although a two-stage operation is required, application of artificial dermis prior to full-thickness skin grafting is a reliable method for resurfacing the nose.
Annals of Plastic Surgery 11/1999; 43(4):439-42. · 1.32 Impact Factor
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ABSTRACT: The planimetric Z-plasty proposed by Roggendorf provides elongation by excision of a pair of triangular pieces of tissue. The application of planimetric Z-plasties has been modified by making the vertical angle flexible, and making them continuous in the same or in opposite directions. Continuous planimetric Z-plasties in the same direction elongate an oblique contracture in the longitudinal direction. Continuous planimetric Z-plasties in an alternative direction elongate a disproportioned scar contracture in the longitudinal direction. Both techniques partially reduce unsightly scarring. Furthermore, they can be used in combination with V-Y-plasties. These modifications permit rational planing of the treatment of complicated scars with contracture.
British Journal of Plastic Surgery 08/1998; 51(5):363-9. · 1.29 Impact Factor
