{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T23:02:51Z","timestamp":1762642971387,"version":"3.28.0"},"reference-count":15,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Facial Plast Surg"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Reconstruction of nasal defects can be challenging, especially when encountering larger defects. We describe the use of a single-stage conversion of an \u2018A\u2019 shaped defect to a \u2018T\u2019 shaped scar of large nasal skin defects in the cosmetically sensitive supra-tip and supra-alar regions. This study aimed to determine whether an A-T flap is a suitable option for nasal reconstruction and if so where and what size defects it can be used for. Retrospective case series review over an 8-year period (2011\u20132019) in a tertiary referral center in the United Kingdom. Case analysis was undertaken in 2020 including all patients who underwent A-T reconstruction of nasal defects. A review of histology, case notes, and clinical photography was undertaken. A total of 27 patients were identified\u201413 (48%) female and 14 (52%) male. The median age was 73 years (range 31\u201390 years). Defect locations were supra-tip (48%) and supra-alar (52%). The largest defect closed was 895\u2009mm2 (30\u2009\u00d7\u200938\u2009mm). Range 35 to 895\u2009mm2 (median 264\u2009mm2). No patient required revision or corrective procedures. No functional impairment was identified. Patient and clinician reported aesthetic outcomes as good in all cases. No reports of this technique could be identified in the literature. The A-T flap is a viable option for supra-tip and supra-alar skin defects (up to 895\u2009mm2 in our series). It aligns well with the basic principles of nasal reconstruction. The flap can be performed under local anesthesia in one stage, resulting in good functional and aesthetic outcomes and so can be considered a valuable tool for the nasal reconstructive surgeon.<\/jats:p>","DOI":"10.1055\/s-0043-1776872","type":"journal-article","created":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T00:14:45Z","timestamp":1701216885000},"page":"493-498","source":"Crossref","is-referenced-by-count":1,"title":["A-T Flap for Reconstruction of Nasal Dorsum Skin Defects"],"prefix":"10.1055","volume":"40","author":[{"given":"Peter","family":"Deutsch","sequence":"additional","affiliation":[{"name":"ENT Department, University Hospitals Birmingham NHS Foundation Trust, Heartlands Hospital, Birmingham, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jack","family":"Limbrick","sequence":"additional","affiliation":[{"name":"ENT Department, University Hospitals Birmingham NHS Foundation Trust, Heartlands Hospital, Birmingham, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shahram","family":"Anari","sequence":"additional","affiliation":[{"name":"ENT Department, University Hospitals Birmingham NHS Foundation Trust, Heartlands Hospital, Birmingham, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,11,28]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1055\/s-0036-1597898","article-title":"Nasal reconstruction involving multiple subunit defects","volume":"33","author":"A Cox","year":"2017","journal-title":"Facial Plast Surg"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"1033e","DOI":"10.1097\/PRS.0000000000002237","article-title":"Principles and planning in nasal and facial reconstruction: making a normal face","volume":"137","author":"F J Menick","year":"2016","journal-title":"Plast Reconstr 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Newlove","year":"2016","journal-title":"Dermatol Surg"},{"issue":"02","key":"ref10","doi-asserted-by":"crossref","first-page":"e57","DOI":"10.1016\/j.jaad.2016.08.037","article-title":"The wingman flap: bilateral closure of a supra-tip defect of the nose","volume":"76","author":"S T Kouwenhoven","year":"2017","journal-title":"J Am Acad Dermatol"},{"issue":"01","key":"ref11","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1055\/s-0036-1597982","article-title":"Local cutaneous flaps in nasal reconstruction","volume":"33","author":"G N Lu","year":"2017","journal-title":"Facial Plast Surg"},{"issue":"01","key":"ref12","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1111\/ddg.14214","article-title":"The combination of the Wilson bridge flap with A-T advancement flap for extensive red lip defects and defects of the skin of the lip","volume":"19","author":"A S Bohne","year":"2021","journal-title":"J Dtsch Dermatol 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