Case report demonstrates successful distal necrosis salvage in a patient using pedicle reconstruction, suggesting an effective alternative approach.
A woman in her 60s developed early venous congestion and distal necrosis following paramedian forehead flap reconstruction of a left alar Mohs defect. The viable proximal PMFF pedicle was repurposed to reconstruct the compromised alar subunit, providing a tissue-sparing salvage technique that avoided a contralateral forehead flap or additional regional donor site. Long-term follow-up demonstrated durable flap viability, preserved nasal airway patency, and favorable alar contour and color match.
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Gates et al. (2026) studied this question.
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