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Reconstruction of nasal alar defects.

OBJECTIVE
To evaluate aesthetic and functional results of reconstruction of the nasal alar subunit using free cartilage grafts with an interpolated cheek or forehead flap and a vascularized mucosal flap when required.


SETTING
University-based facial plastic surgery practice.


PATIENTS
A case series of 50 patients with primary alar defects undergoing nasal alar reconstruction.


MAIN OUTCOME MEASURES
Observer's and patient's rating of the final results, patient's rating of breathing and level of self-consciousness, and medical record review of complications.


RESULTS
Most aesthetic outcomes were excellent to good. Breathing from the reconstructed side can be returned to preoperative status in most of these patients.


CONCLUSION
Staged reconstruction of the nasal ala using free cartilage grafts, interpolated cheek or forehead and mucosal flaps when necessary, result in a highly aesthetic and functional outcome in most patients.