Nasal Surgical Defects: Reconstruction with Modified PENG Flap

Abstract

INTRODUCTION: The Peng flap is a pinch modification of linear advancement flap (Rintala flap). Its purpose is to close surgical defects in the tip and distal dorsum of the nose. It was initially described by Peng (classic Peng flap) and revised, later, by Rowe and Ahern (modified Peng flap). Our objective was to describe classic and modified Peng flap (Rowe’s and Ahern’s techniques), and we report the results achieved according to Ahern’s technique.
MATERIAL AND METHODS: Three cases of reconstruction of skin defects in the nose were performed using the modified Peng flap (Ahern’s technique). All the patients had skin cancer. The surgery was executed in single operative time under local anaesthesia.
RESULTS: Good functional and aesthetic results were achieved. There were no complications.
DISCUSSION: Ahern’s technique is the one that shows greater dynamism (mobilization of the nasal and malar skin), versatility (closure of lateral and median defects) and capacity to preserve the nasal anatomy and aesthetic (incisions at the junction of the nasal subunits and facial units). In general, the procedures are feasible in a single operative time under local anaesthesia. Partial and total flap failure is uncommon, particularly with Ryan’s technique.
CONCLUSION: The Peng modified flap (Ahern’s technique) revealed to be effective, safe and a good alternative to the classic modalities performed in the reconstruction of the nasal tip.