Journal Information
Vol. 110. Issue 1.
Pages 2 (January - February 2019)
Vol. 110. Issue 1.
Pages 2 (January - February 2019)
Case and Research Letters
Full text access
Correction of Trapdoor Effect Following Nasal Pyramid Reconstruction With a Transposition Flap
Corrección de la deformidad en trampilla secundaria a colgajos de trasposición en pirámide nasal
P. Redondo
Departamento de Dermatología, Clínica Universidad de Navarra, Pamplona, Navarra, España
Article information
Full Text
Download PDF
Full Text

The trapdoor effect is a common medium- to long-term postoperative complication after closure of some facial skin defects with local flaps. Transposition flaps are particularly susceptible to this complication. Compared with geometric Limberg or Dufourmentel flaps, the risk of such complications is accentuated with the lobed flaps with rounded borders used on the nasal pyramid. Treatment of the trapdoor defect is not easy and the technique proposed by Correa et al.1 provides a satisfactory outcome. It may be that the effectiveness of the approach, with reduction of the step without scarring or hypertrophy, is due to the depth of the shaving, which in turn depends on the degree of bulging. The nasal skin has abundant sebaceous glands and so superficial shaving that does not go beyond the glandular epithelium granulates and epithelizes more quickly, without the risk of a hypertrophic scar associated with procedures that extend beyond this level to reach subcutaneous tissue free of adnexal structures. We bear this in mind when we surgically profile the nose of a patient with rhinophyma through curettage and electrocauterization. We know from experience that hypertrophic scarring may occur if we reach too deep and, by analogy, this may also be the case with supershaving. To prevent hypertrophic scarring, it would be necessary to agree with the patient to perform a more superficial curettage, with the option of repetition if the first procedure was not sufficient, before performing an initial deeper one with possible side effects. The same applies when curettage of an intradermal nevus is performed for aesthetic reasons. It is preferable not to aim for excessive depth and leave a small bulge that can be corrected in a second procedure rather than leave a depressed scar that is much harder to correct at a later date.

J. Correa, J. Magliano, I. Peres, C. Bazzano.
Afeitado profundo («super shaving») para la corrección del efecto trampilla de colgajos nasales.
Actas Dermosifiliogr, 110 (2019), pp. 32-36

Please cite this article as: Redondo P. Correction of Trapdoor Effect Following Nasal Pyramid Reconstruction With a Transposition Flap. Actas Dermosifiliogr. 2019;110:2.

Actas Dermo-Sifiliográficas (English Edition)

Subscribe to our newsletter

Article options
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?