{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T14:44:42Z","timestamp":1776696282819,"version":"3.51.2"},"reference-count":8,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Despite advances in cleft rhinoplasty, the nasal sill remains an underappreciated subunit, yet it plays a crucial role in nostril symmetry and aesthetic balance. Hypoplasia or absence of the nasal sill on the cleft side often persists after primary repair and may complicate secondary nasal base correction. Current methods for sill reconstruction are limited by donor site morbidity, variability in tissue match, or non-anatomic tissue substitution. Methods: This technical note describes a surgical protocol utilizing the Tela Cutis Nasi flap, a pedicled fibro-adipose flap harvested from the adjacent nasal base, to reconstruct the deficient sill in patients with previously repaired unilateral cleft lip. The flap concept, anatomical rationale, stepwise operative steps, and patient selection considerations are outlined. Results: This technical note details the surgical steps, anatomical rationale, and flap design. No formal morphometric or patient-reported outcome analysis is included in this report; these data are being collected within an ongoing prospective outcome study designed to evaluate efficacy and long-term stability. Conclusions: The Tela Cutis Nasi flap is intended as an anatomically based local option for nasal sill reconstruction that can be integrated into secondary cleft nasal base surgery. This article contributes a standardized operative description, indications, technical constraints, and anticipated pitfalls, without assessment of clinical outcomes or long-term stability.<\/jats:p>","DOI":"10.3390\/jcm15083139","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T13:22:47Z","timestamp":1776691367000},"page":"3139","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Tela Cutis Nasi Flap: A Technical Note on Nasal Sill Reconstruction in Secondary Cleft Rhinoplasty"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5533-4057","authenticated-orcid":false,"given":"\u0141ukasz","family":"Banasiak","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery, Regional Specialist Hospital in Olsztyn, 10-228 Olsztyn, Poland"},{"name":"Center for Craniofacial Anomalies, Voivodeship Children\u2019s Hospital in Olsztyn, 10-561 Olsztyn, Poland"},{"name":"Department of Otolaryngology, Audiology and Phoniatrics, Collegium Medicum, Nicolaus Copernicus University in Toru\u0144, 85-067 Bydgoszcz, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1037-3711","authenticated-orcid":false,"given":"Oskar","family":"Komisarek","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Regional Specialist Hospital in Olsztyn, 10-228 Olsztyn, Poland"},{"name":"Department of Otolaryngology, Audiology and Phoniatrics, Collegium Medicum, Nicolaus Copernicus University in Toru\u0144, 85-067 Bydgoszcz, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8109-4696","authenticated-orcid":false,"given":"Vanessa","family":"Olichwer","sequence":"additional","affiliation":[{"name":"Students Scientific Association of Maxillofacial Surgery, Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University in Toru\u0144, 85-067 Bydgoszcz, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pawe\u0142","family":"Radkowski","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Regional Specialist Hospital in Olsztyn, 10-228 Olsztyn, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pawe\u0142","family":"Burduk","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Audiology and Phoniatrics, Collegium Medicum, Nicolaus Copernicus University in Toru\u0144, 85-067 Bydgoszcz, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7605-2080","authenticated-orcid":false,"given":"Krzysztof","family":"Dowgierd","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Regional Specialist Hospital in Olsztyn, 10-228 Olsztyn, Poland"},{"name":"Center for Craniofacial Anomalies, Voivodeship Children\u2019s Hospital in Olsztyn, 10-561 Olsztyn, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1002\/ohn.1299","article-title":"Secondary columellar lengthening in bilateral nasal cleft deformities with a sliding flap cheilorhinoplasty","volume":"173","author":"Frederick","year":"2025","journal-title":"Otolaryngol.\u2013Head Neck Surg."},{"key":"ref_2","first-page":"631","article-title":"Cleft nasal deformity and rhinoplasty: Review article","volume":"14","author":"Hassan","year":"2023","journal-title":"J. Pharm. Negat. Results"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/s40902-021-00298-3","article-title":"Nasal sill augmentation: An overlooked concept in rhinoplasty\u2014A technical note and review of the literatures","volume":"43","author":"Adham","year":"2021","journal-title":"Maxillofac. Plast. Reconstr. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/s40902-015-0035-z","article-title":"Double-layered reconstruction of the nasal floor in complete cleft deformity of the primary palate using superfluous lip tissue","volume":"37","author":"Park","year":"2015","journal-title":"Maxillofac. Plast. Reconstr. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1097\/01.scs.0000231628.10511.bb","article-title":"Various applications of chondrocutaneous composite grafts in secondary cleft lip nose patients","volume":"17","author":"Ayhan","year":"2006","journal-title":"J. Craniofacial Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e410","DOI":"10.1097\/GOX.0000000000000390","article-title":"Subcutaneous nasolabial flap for eliminating depressed nasal floor in adult cleft rhinoplasty: Technical note","volume":"3","author":"Rahpeyma","year":"2015","journal-title":"Plast. Reconstr. Surg.\u2013Glob. Open"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2969","DOI":"10.1007\/s00266-024-04526-9","article-title":"A novel classification of nasal sill morphology provides strategies for secondary cleft rhinoplasty","volume":"49","author":"Xia","year":"2024","journal-title":"Aesthetic Plast. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.fsc.2008.10.002","article-title":"Cleft Lip Rhinoplasty","volume":"17","author":"Sykes","year":"2009","journal-title":"Facial Plast. Surg. Clin. N. Am."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/8\/3139\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T13:53:19Z","timestamp":1776693199000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/8\/3139"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,20]]},"references-count":8,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["jcm15083139"],"URL":"https:\/\/doi.org\/10.3390\/jcm15083139","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,20]]}}}