Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Jul 27;13(7):e16657.
doi: 10.7759/cureus.16657. eCollection 2021 Jul.

The Navicular Graft for Reconstructing Deep Alar Defects

Caitlin Robinson  1 , Nader Aboul-Fettouh  2 , Timothy Hansen  3 , Sogyong L Auh  4 , Deborah F MacFarlane  5
Affiliations
Case Reports

The Navicular Graft for Reconstructing Deep Alar Defects

Caitlin Robinson et al. Cureus. .

Abstract

The reconstruction of deep nasal ala defects can be challenging. The often thick, sebaceous skin of the nose provides structural support helping maintain the ala shape and nasal patency; loss of this support may result in ala deformity and nasal vestibule collapse. Traditional full-thickness skin grafts of deep alar defects may result in depressed scars. We present a variation of the full-thickness skin graft to repair deeper alar defects, sculpting the graft into a boat-shaped or "navicular" form. This allows for sufficient volume restoration and good cosmesis while avoiding more extensive surgical repairs of the nasal ala. The navicular graft offers several advantages: the avoidance of more extensive procedures involving cartilage grafts and/or flaps, appropriate color/texture match, and volume restoration without pitting, notching, or retraction of nasal structures. In addition, no struts or bolsters are needed.

Keywords: full-thickness skin graft; mohs surgery; nasal ala; reconstruction; skin cancer; skin graft.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. A full-thickness skin graft harvested from the glabellar skin
The graft was sculpted into a “boat” shape, which filled the depth of the defect and was slightly narrower than the defect diameter.
Figure 2
Figure 2. Patient 1
(A) Post-surgical defect. (B) Navicular graft sutured in place. (C) At four-month follow-up.
Figure 3
Figure 3. Patient 2
(A) Post-surgical defect. (B) Navicular graft sutured in place. (C) At seven-month follow-up.
Figure 4
Figure 4. Patient 3
(A) Post-surgical defect. (B) Navicular graft sutured in place. (C) At one-month follow-up.
See this image and copyright information in PMC

References

    1. Composite skin grafts for basal cell carcinoma defects of the nose. Gurunluoglu R, Shafighi M, Gardetto A, Piza-Katzer H. Aesthetic Plast Surg. 2003;27:286–922. - PubMed
    1. Leave the fat, skip the bolster: thinking outside the box in lower third nasal reconstruction. Hubbard TJ. Plast Reconstr Surg. 2004;114:1427–1435. - PubMed
    1. Skin-fat-graft: a simple tool for reconstruction of small deep defects of the nose. Kreutzer C, von Gregory HF, Fischer H. Facial Plast Surg. 2014;30:247–259. - PubMed
    1. Composite full-thickness skin and fat graft for nasal reconstruction. Olazagasti J, Kleinerman R, Eisen DB. Dermatol Surg. 2014;40:337–340. - PubMed
    1. Full-thickness skin grafts may not need tie-over bolster dressings. Shimizu I, MacFarlane DF. Dermatol Surg. 2013;39:726–728. - PubMed

Publication types

LinkOut - more resources