Nasal Reconstruction (rebuilding the nose after skin cancer using a bilobed flap)

Explore nasal reconstruction after basal cell skin cancer, nasal surgery, & sculpture of the nose by Dr. Michael Bermant, MD plastic & cosmetic surgery.

Michael Bermant, MD
Board Certified by the American Board of Plastic Surgery

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Basal Cell Skin Cancer

This page shows several of my patients with basal cell skin cancer who were reconstructed with a bilobed flap (skin moved from one location to another with the blood supply preserved).

Bilobed Flap Nasal Reconstruction Case 1

The lesion

basal cell cancer nose - plastic and reconstructive surgery

Basal cell cancer of nose. Excision shown in the photographs below was done with modified Mohs' surgery control of margins. The surgeon works closely with the pathologist analyzing tissue as it is removed. This allows fine control of tumor removal ensuring that the tumor has no tiny extensions missed.

Bilobed Flap Nasal Reconstruction Case 1

 The lesion

After excision flap design

basal cell cancer nose 2- plastic and reconstructive surgery

basal cell cancer nose flap reconstruction - plastic and reconstructive surgery 

This flap design has two components. The adjacent larger component fills the excision defect. The smaller second part fills the larger donor defect. I think the flap design looks like a bunny rabbit with the ear on top, but in textbooks it is called the bilobed flap.

 

Bilobed Flap Nasal Reconstruction Case 1

Flaps rotated into place

After healing

basal cell cancer nose after flap inset- plastic and reconstructive surgery

 basal cell cancer nose result- plastic and reconstructive surgery

The flaps have been rotated into place. A fold of skin at the base of the flap resolves over time as seen in the after surgery photograph. Such tissue sculpting is part of the artistry of plastic and cosmetic surgery.

 

Bilobed Flap Nasal Reconstruction Case 2

 The lesion

basal cell cancer nose - plastic and reconstructive surgery Dr. Michael Bermant plastic surgeon

 basal cell cancer nose - plastic and reconstructive surgery Dr. Michael Bermant plastic surgeon

This patient has a basal cell carcinoma of the nose left to grow to this height.

 

Bilobed Flap Nasal Reconstruction Case 2

Flap design

basal cell cancer nose - plastic and reconstructive surgery Dr. Michael Bermant plastic surgeon rhimoplaty

 flap design basal cell cancer nose - plastic and reconstructive surgery Dr. Michael Bermant plastic surgeon

Here is a drawing of the defect and the planned plastic surgical reconstruction with a bilobed flap design.

 

Bilobed Flap Nasal Reconstruction Case 2

The healed reconstruction

cosmetic result basal cell cancer nose - plastic and reconstructive surgery Dr. Michael Bermant plastic surgeon

result basal cell cancer nose - plastic and reconstructive surgery Dr. Michael Bermant plastic surgeon

Here are the results. Notice the natural contour and shape of the nasal tip.

 

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