CC BY 4.0 · Arch Plast Surg 2024; 51(04): 367-371
DOI: 10.1055/a-2309-1701
Pediatric/Craniomaxillofacial/Head & Neck
Idea and Innovation

The Reconstruction of the Nasal Columella Defect Using Domino Flaps

1   Center for Craniofacial and Plastic Surgery, 108 Military Central Hospital, Hanoi, Vietnam
1   Center for Craniofacial and Plastic Surgery, 108 Military Central Hospital, Hanoi, Vietnam
1   Center for Craniofacial and Plastic Surgery, 108 Military Central Hospital, Hanoi, Vietnam
2   Department of Plastic and Reconstructive Surgery, Hanoi Medical University, Hanoi, Vietnam
1   Center for Craniofacial and Plastic Surgery, 108 Military Central Hospital, Hanoi, Vietnam
1   Center for Craniofacial and Plastic Surgery, 108 Military Central Hospital, Hanoi, Vietnam
› Author Affiliations


Skin defects of the total nasal columella can significantly impact both nasal respiratory function and aesthetics. The reconstruction of total columella is a complex process and represents a significant challenge for plastic surgeons. Various factors can cause the loss of the columella. Numerous columella reconstruction procedures have been proposed, each with their own set of advantages and disadvantages. The main issues to address include the need for regional flaps from the forehead or nasofacial sulcus, a long pedicle to reach the columella, and the double angular folding that causes a risk of malnutrition or venous congestion. Additionally, using horizontal nasolabial flaps may lead to deformation of the upper lip.

In this study, we present a new procedure to reconstruct the nasal columella using “Domino flaps” with two flaps (the horizontal upper lip island flap and nasocheek island flap). This new procedure ensures adequate skin for reconstruction of nasal columella and partial tip, minimizes rotation angle, reduces the angular folding of the pedicle, furthermore limits deformation of the upper lip. “Domino flaps” are a valuable option for surgeons when reconstructing the total nasal columella. However, it is important to consider whether the patient has a beard at the donor sites.

Authors' Contributions

Conceptualization: L.D.L., N.Q.D., V.N.L., L.P.L., N.P.T., N.Q.M.

Writing - original draft: L.D.L., N.Q.D., V.N.L., L.P.L., N.P.T., N.Q.M.

Writing - review & editing: L.D.L., N.Q.D., N.P.T.

Ethical Approval

Ethical approval was obtained from institutional review board of local faculty and the participating hospital.

Patient Consent

The patient's parent provided written informed consent for the publication and the use of his images.

Publication History

Received: 08 January 2024

Accepted: 15 April 2024

Accepted Manuscript online:
18 April 2024

Article published online:
19 June 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (

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