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.