Nasal Dorsum Transposition Flap for Closure of an Alar Rim Defect

A 60-year-old Caucasian presented with islands of atypical basaloid cells with peripheral palisading within the dermis, consistent with a basal cell carcinoma. Mohs micrographic surgery cleared the tumor, but resulted in a surgical defect of the right nasal ala and nasal ala rim. Primary closure of any defect is preferred if it can be accomplished without visible tissue distortion. In this patient there was not enough adjacent skin available for a primary closure. After careful consideration, the doctors decided on a transposition flap from the nasal dorsum to repair a large defect of the right nasal ala and rim, preserving its size, contour, and function. This had the advantage of using adequate local qualitatively similar skin with a self-contained blood supply and the ability to preserve the contour and function of the nasal ala and groove. The secondary defect was closed in a side-to-side fashion, achieving an excellent esthetic result.