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Second-intention healing of nasal alar defects.

Dermatologic surgeons frequently perform the reconstruction of nasal defects after excision of cutaneous malignancies. Restoration of each nasal subunit presents its own complexities and should be assessed individually. Nasal ala reconstruction can be especially challenging because of the three-dimensional projection of the ala, limited overlying tissue mobility, need for preservation of the alar groove, and potential for free margin distortion. Given the central face location, achieving symmetry with the contralateral ala and surrounding anatomic structures is also a critical aesthetic consideration. A variety of approaches have been described for these defects, including skin grafts and various flaps.