A modified bilobed flap design for nasal tip defects

Aim: The correction of nasal tip defects presents many challenges. Zitelli’s bilobed flap has been widely used for such repairing defects, but may be complicated by interrupted scars on the nasal dorsum. Our study evaluates the design principles, results, and advantages of a modified bilobed flap for repairing nasal tip defects.Methods: The primary lobe was located between the defect and the cheek, and the second lobe was located in the cheek. The width of the primary lobe was equal to that of the primary defect. The length of the primary lobe was 10% longer than the distance of the distal defect edge to the pivot point of the flap. The length of the second lobe was 30% longer than the distance of the distal defect edge to the pivot point of the flap. The width of the second lobe was 90-100% of that of the primary lobe. The ability to close the defect under minimal tension, the cosmetic appearance, and any complications were evaluated.Results: This technique was performed in 34 cases; defect size ranged from 0.8 cm × 0.9 cm to 1.2 cm × 1.8 cm. All defects were closed under minimal wound tension, all scars were inconspicuous, no obvious complications occurred, and the aesthetic outcomes were considered favorable.Conclusion: The modified bilobed flap can provide satisfying outcomes with lower morbidity and inconspicuous scarring. It is simple and suitable for repairing small- to medium-sized defects in the nasal tip