Tunneled Interpolated Flaps in the Reconstruction of Nasal Defects

Keywords: Nasal Cartilages, Nose/surgery, Reconstructive Surgical Procedures, Rhinoplasty/methods, Surgical Flaps


The reconstruction of nasal skin defects is a challenge even for an experienced dermatological surgeon. When the defect is too large or complex to be corrected with simpler flaps, interpolated flaps are a good option, but they usually require two surgeries. Tunneled interpolated flaps were developed to allow the reconstruction of complex defects in only one surgical procedure. In nasal reconstruction, the main tunneled flaps are the paramedian forehead and the melolabial flaps. This review will focus on these two flaps: description of the technique, applications, advantages and disadvantages.


Download data is not yet available.


Santos G, Goulão J. Complex reconstruction of defect of the lower third of the nose. Rev Soc Port Dermatol Venereol. 2013;71:193-196. doi: https://doi.org/10.29021/spdv.71.2.170.

Bolognia J, Schaffer J, Cerroni L. Dermatology. 4th ed. Elsevier; 2018.

Baker S. Local flaps in facial reconstruction. 3rd ed. Elsevier; 2014.

Goulão J, Furtado C. Flap reconstruction for the middle two-thirds of the nose. Rev Soc Port Dermatol Venereol. 2011;69:237-240. doi: https://doi.org/10.29021/spdv.69.2.610.

Matos D, Goulão J. Superiorly based nasolabial transposition flap fundamentals. Rev Soc Port Dermatol Venereol. 2014;72:513-523. doi: https://doi.org/10.29021/spdv.72.4.320.

Smart RJ, Yeoh MS, Kim DD. Paramedian forehead flap. Oral Maxillofac Surg Clin North Am. 2014;26:401-410. doi: 10.1016/j.coms.2014.05.008.

Menick FJ. Nasal reconstruction. Plast Reconstr Surg. 2010;125:138e-150e. doi: 10.1097/PRS.0b013e3181d0ae2b

Burget GC, Menick FJ. The subunit principle in nasal reconstruction. Plast Reconstr Surg. 1985;76:239-247. doi: 10.1097/00006534-198508000-00010

Park SS. The single-stage forehead flap in nasal reconstruction: an alternative with advantages. Archives of Facial Plastic Surgery. 2002;4:32-36. doi: 10.1001/archfaci.4.1.32.

Skaria AM. The median forehead flap reviewed: a histologic study on vascular anatomy. Eur Arch Otorhinolaryngol. 2015;272:1231-1237. doi: 10.1007/s00405-014-3027-1

Gouveia MP, Gouveia AI, Brinca A, Vieira R. Tunneled island flaps in facial defects reconstruction. An Bras Dermatol. 2017;92:151-153. doi: 10.1590/abd1806-4841.20175565.

Hollmig ST, Leach BC, Cook J. Single-stage interpolation flaps in facial reconstruction. Dermatol Surg. 2014;40:62-70. doi: 10.1097/01.DSS.0000452737.15655.7a.

Andrade P, Serra D, Cardoso JC, Vieira R, Freitas JD, Figueiredo A. Melolabial fold interpolated flap for reconstruction of complex nasal defects. Rev Soc Port Dermatol Venereol. 2011;69-437-441. doi: https://doi.org/10.29021/spdv.69.3.80.

Krishnan RS, Clark DP, Donnelly HB. Tunneled transposition flap for reconstruction of defects of the nasal ala. Dermatol Surg. 2007;33:1496-1501. doi: 10.1111/j.1524-4725.2007.33323.x.

Mahlberg MJ. Tunneled melolabial pedicle flap for small but deep lateral alar rim defect. Dermatol Surg. 2013;39:1527-1529. doi: 10.1111/dsu.12202.

Kearney C, Sheridan A, Vinciullo C, Elliott T. A tunneled and turned-over nasolabial flap for reconstruction of full thickness nasal ala defects. Dermatol Surg. 2010;36:1319-1324. doi: 10.1111/j.1524-4725.2010.01631.x.

Spear SL, Kroll SS, Romm S. A new twist to the nasolabial flap for reconstruction of lateral alar defects. Plast Reconstr Surg. 1987;79:915-920. doi: 10.1097/00006534-198706000-00010.

How to Cite
Bonito, F., Pinho, A., Brinca, A., Goulão, J., & Vieira, R. (2021). Tunneled Interpolated Flaps in the Reconstruction of Nasal Defects. Journal of the Portuguese Society of Dermatology and Venereology, 79(1), 47-52. https://doi.org/10.29021/spdv.79.1.1314
Review Articles