Reconstruction of the columella

]3ritish Journal of Plastic Surgery (I972), 25, 37-38

RECONSTRUCTION OF THE COLUMELLA By ISAAC KAPLAN Department of Plastic and Maxillo-Facial Surgery, Beilinson Hospital and Tel Aviv University Medical School, Israel MANY procedures for reconstructing the columella have been described ; it is not the purpose of this article to discuss their pros and cons but merely to report a method used with gratifying results, in our department. In cases where only the columella requires reconstruction, bilateral inferiorly based naso-malar island flaps are prepared (based on the anterior facial vessels), and having been brought into position through a tunnel under the skin of the upper lip are sutured to each other and the defect (Figs. 1-4).

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FIG. 2

FIG. I

FIG. 3

FIG. 4

FIG. I. - - S h o w i n g the defect. FIG. 2.--IUustrating the preparation of the island flaps. FIG. 3.--Island flaps brought into position. FIG. 4.--After closure of donor sites.

A concomitant defect in the upper lip may be repaired at the same time with similarly based rotation flaps, the terminal portions of which are used for reconstruction of the columella. Figures 5-IO illustrate a case of primary single-stage reconstruction of the upper half of the lip and the columella following radical excision of a carcinoma. 37

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B R I T I S H JOURNAL OF PLASTIC SURGERY

FIG. 5 . - - T h e specimen after radical excision of the carcinoma. FIG. 6.--Showing the resultant defect. FIG. 7.--Inferior view at completion of reconstruction. FIG. 8.--Profile view at completion of reconstruction. Note: Donor site of naso-malar flap. FIG. 9.--Condition 3 weeks post-operatively. FiG. xo.--Condition 3 weeks post-operatively.