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The Rintala flap revisited.

We describe nasal tip reconstruction using a superiorly based midline Rintala flap. Good tissue coverage and excellent flap viability, color match, and nasal contour make this flap a good alternative for reconstructing large nasal tip defects without using forehead flaps. Up to half the superior columella can be reconstructed simultaneously by using this single-stage technique with the patient under local anesthesia. Adjunctive procedures such as tip rhinoplasty and bilateral cheek flap advancement can add to the utility of this flap and are discussed along with general techniques and case examples.