LAUSR

Nasal tissue defects cause major disturbances to patients’ lives. Many concerns not only center on cosmetic implications but also on surgery itself, recovery time, and cost. Fortunately, several reconstructive techniques exist to restore a natural appearance, including the novel miniSMAS flap reconstruction which is the most advantageous reconstructive option in some cases. Surgical tolerance must be considered when choosing reconstructions. For patients with multiple comorbidities, we attempt to reduce the operative time. Four patients had major cardiopulmonary diseases, making multistage surgery less favorable. When nasal defects involve the exposed cartilage or bone, FTSG or STSG reconstruction alone will likely die, and extensive or 2-stage reconstructive options may be refused by the patient because of concern for scaring, disfigurement, and impairment between operations. Furthermore, granulation tissue formation may be insufficient, prolonging wound healing and leading to complications such as chondritis or necrosis. Skin grafting onto a mini-SMAS flap limits these concerns. This report describes the technique and efficacy of miniSMAS flaps for nasal reconstruction in poorly vascularized wounds. The vascularized SMAS provides ample support for overlying skin grafts. Only one patient has a poor result; we postulate that perioperative smoking contributed significantly to this outcome. Themini-SMAS flap is a useful reconstructive technique for skin grafting over the exposed cartilage or bone in patients who desire minimal surgery or have poor surgical tolerance.