Combining flaps. Medical canthal/lateral nasal root reconstruction utilizing glabellar "fan" and cheek rotation flaps--an O-to-Z variation.

An increased use of multiple flaps applied to single reconstructive problems is encouraged. Removal of a basal cell carcinoma involving the medial canthus and adjacent lateral nasal root skin resulted in significant defect. When a glabellar "fan" flap failed to provide adequate tissue for canthal reconstruction without undue distortion, a preplanned medial cheek rotation flap followed sequentially in the repair process. The basic principles of an O-to-Z flap reconstruction were therefore fulfilled by conjoining two different flap design applications.