Update on the Septal Pivot Flap

Abstract

The septal pivot flap has been an integral part of my concept for total and subtotal nasal repair. Since 2004, I have performed 15 reconstructions, in 9 cases combined with a pivot flap. The three-stage procedure starts with reconstruction of the septum by lifting the flap if available and needed. In the nine patients, all flaps could be rotated smoothly and without necrosis, contributing a minor or even major portion of nasal lining in every case. The neoseptum provided a strong static support, thus preparing the ground for significantly good projection, protection, and definition of profile and tip. This article illustrates the basic technique step by step and presents four typical cases.

Keywords

septal pivot flap - septal composite flap - total nasal reconstruction

• References

• 1 Hett GS. The use of the turbinals and the septum in the repair of injuries and defects of the wall of the nasal cavity. Lancet 1917; 190: 892-897
• 2 Gilles HD. Plastic Surgery of the Face. London: Frowde, Hodder, Stoughton; 1920: 270
• 3 Burget GC, Menick FJ. Nasal support and lining: the marriage of beauty and blood supply. Plast Reconstr Surg 1989; 84 (2) 189-202
• 4 Burget GC, Menick FJ. Aesthetic Reconstruction of the Nose. St. Louis, MO: Mosby; 1994: 315-323
• 5 Quetz J, Ambrosch P. Total nasal reconstruction: a 6-year experience with the three-stage forehead flap combined with the septal pivot flap. Facial Plast Surg 2011; 27 (3) 266-275