A subcutaneous pedicled cheek flap for reconstruction of alar defects.

The anatomy of the blood supply around the alar region was studied and showed that a large flap of nasolabial skin would survive on a narrow subcutaneous pedicle containing sufficient arteries and veins to justify the term "axial patterned flap". The secondary defect is closed with another nasolabial flap. In many cases a definitive single stage repair may be achieved. In others, some secondary revision has been required.