Nasal alar and lobule reconstruction – Case presentation

Aurelian Radu Budurca 1 , 2 , Teodor Stamate 1 , 2 , Mihail Dan Cobzeanu 1 , 3  and Angelica Balaur 2
  • 1 “Gr. T. Popa” University of Medicine and Pharmacy, Iasi, Romania
  • 2 Plastic and Reconstructive Surgery Department, “Sfantul Spiridon” County Emergency Hospital, Iasi, Romania
  • 3 ENT&HNS Department, “Sfantul Spiridon” County Emergency Hospital, Iasi, Romania


We present a reconstruction of a posttraumatic nasal lobular and alar defect in a three-stage intervention. The first operation restored the cartilaginous support by a combination of a free conchal composite graft and a septal chondromucosal pivotal flap covered by a paramedian forehead pedicled flap. The second operation separated the pedicle of the flap, followed one month later by cosmetic refinements. We restored both length and shape of the nose and a functional symmetrical nostril. Surgical options are discussed regarding available donor areas and techniques.

Conclusion. Lobule reconstruction must be performed as an entire esthetic unit and must address all three layers - skin, cartilage and internal lining. Careful planning is fundamental in ensuring good cosmetic results.

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