Rhinophyma graft for repair of the phymatous nasal ala

Nasal reconstruction in the setting of rhinophyma poses some unique challenges. Traditional options for nasal ala reconstruction, such as bilobed flaps, nasolabial transposition flaps, and skin grafts, are often unable to provide an adequate tissue match for rhinophymatous skin. Second intention healing is a viable option for small defects on concave surfaces, but there is a risk of alar notching at the free margin. We present a unique technique for reconstruction of a 1.4 cm nasal ala defect with concomitant moderate rhinophyma after Mohs micrographic surgery.

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