BILOBED FLAPS

Course overview

THE BILOBED FLAP IS A LOCAL FLAP USED PRIMARILY FOR THE RECONSTRUCTION OF SMALL TO MODERATE CUTANEOUS NASAL DEFECTS. IT WAS FIRST DESCRIBED IN 1918 BY ESSER FOR USE IN NASAL TIP RECONSTRUCTION. THE ORIGINAL FLAP USED A ROTATIONAL ARC OF 180 DEGREES AND BASED THE SECOND LOBE SUPERIORLY TOWARDS THE GLABELLAR REGION. IN 1953 ZIMANY DEMONSTRATED THAT THE SECOND AND THIRD LOBES COULD BE SMALLER THAN THE FIRST AND THAT THE FLAP COULD BE UTILIZED FOR RECONSTRUCTION IN MORE ANATOMICAL AREAS. IN THE 1980S MCGREGOR AND SOUTAR INTRODUCED THE CONCEPT THAT A REDUCED PIVOTAL ANGLE WOULD RESULT IN SMALLER STANDING CUTANEOUS DEFORMITIES AND DECREASED PIN-CUSHIONING. ZITELLI WENT ONTO TO DESCRIBE LIMITING THE TOTAL ROTATIONAL ARC TO BETWEEN 90 TO 110 DEGREES. THIS IS THE MOST COMMON MODIFICATION IN USE TODAY. THIS OVERVIEW OF THE BILOBED FLAP WILL FOCUS ON THE MOST RECENT MODIFICATION. IT WILL DESCRIBE THE RELEVANT ANATOMY, THE SITUATIONS IN WHICH YOU MIGHT CHOOSE TO USE THE BILOBED FLAP, AND DESCRIBE IN DETAIL HOW TO PLAN AND EXECUTE THIS VALUABLE FLAP.