Bilobed Flap for Nasal Ala Reconstruction After Basal Cell Carcinoma Excision: Principles, Technique, and Outcomes

Overview & Synopsis

Background:Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer, with the nasal ala being a high-risk region because of its convex shape, chronic ultraviolet exposure, and limited skin laxity. Surgical excision remains the definitive management, but reconstruction poses significant aesthetic and functional challenges. Objective:To provide an in-depth review of bilobed flap design, indications, technical nuances, and outcomes for reconstruction of nasal alar defects following BCC excision, highlighting aesthetic subunits and modern geometric refinements. Methods:A comprehensive synthesis of established anatomical, oncological, and reconstructive concepts is presented, supported by key publications in nasal reconstruction. Conclusion:When used in accordance with modern principles, the bilobed flap is a reliable, single-stage solution for small to moderate nasal alar defects after BCC excision, offering excellent contour restoration and minimal morbidity.