Patient - Reconstruction

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Click on an image below to see a larger version.

Before

This lady presented with a biopsy proven malignant melanoma in situ of the right nostril. This is the earliest form of melanoma and, if completely excised, should be reliably cured. Excision requires a generous margin of normal skin, on the order of 5 mm or more. In her case, this required removal of essentially the entire nostril. I reconstructed her with a flap of skin and fat taken from the right cheek, called a nasolabial flap. This required two operations to accomplish. 

The melanoma (arrow) is an unimpressive patch of very faint brown pigment. 

The melanoma has been removed and the flap from the inner cheek has been lifted, rotated over to the nose, and wrapped on itself to form a new nostril.

At the second operation, the base of the flap has been divided, the flap has been trimmed to thin it and shape into something resembling the normal nostril. 

After

She is shown about 8 months after the first surgery. The flap has settled in nicely and looks quite inconspicuous.