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Nasal reconstruction - all problems have more than one solution. This was a very difficult defect over this lovely woman’s infratip area after Mohs micrographic surgery that included her soft triangle. You can see both options that were initially drawn out as a teaching exercise for my fellow, which led to a great deal of discussion surrounding the pros and cons of our two options: a dorsal nasal rotation flap versus a trilobe transposition flap.

In the end, we elected for the dorsal nasal rotation flap for two reasons: we wanted to hide the incision away from her midline along the junction of cosmetic subunits on her nasal sidewall, and we wanted to correct a slight amount of nasal tip ptosis that had come with aging. That created a nice little bonus cosmetic outcome to her reconstruction!

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