Reconstruction of Tip, Dorsum, Sidewalls, and Ala Open image in new window
The patient was a 62-year-old woman seen in consultation for basal cell carcinoma of the nose. Ten years earlier, she had undergone a trichophytic forehead lift and cervicofacial rhytidectomy. Physical examination revealed extremely thin nasal skin showing the outline of her delicate alar cartilages. A scaly lesion involved the skin covering the nasal tip and a portion of the left sidewall. The tumor extended inferiorly to the junction of the tip and columella and appeared to involve most of the skin of the right ala (Fig. 19.1). The patient had a relatively high forehead and a trichophytic scar that extended the full length of the anterior hairline.