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John A. Zitelli, MD

Arch Facial Plast Surg. 2008;10(3):186.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Zoumalan et al¹ demonstrate a very important design aspect of the bilobed flap: that closure of the secondary defect should be as vertical as possible to avoid distortion of the alar rim. In many published photographs of the bilobed flap, one can see that secondary closures that are not perpendicular to the alar rim will usually result in distortion to either the ipsilateral or contralateral alar rim.

Some clinical variables can help to predict the possibility of alar position postoperatively. First, the larger the primary defect, and therefore the larger the secondary defect, the more likely there will be distortion. This possibility is magnified if the skin is tight over the nasal dorsum and side walls, limiting the amount of skin available for closure. In the situation of large defects or tight skin, it is very important to orient the secondary defect perpendicular to the alar . . . [Full Text of this Article]

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RELATED ARTICLE

Analysis of Vector Alignment With the Zitelli Bilobed Flap for Nasal Defect Repair: A Comparison of Flap Dynamics in Human Cadavers
Richard Abraham Zoumalan, Carole Hazan, Vicki J. Levine, and Anil R. Shah
Arch Facial Plast Surg. 2008;10(3):181-185.
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