Zitelli bilobed flap for the reconstruction of the nasal pyramid after excision of basal cell carcinoma (BCC)

We report the case of a 65-year old patient presenting with well-defined nodular basal cell carcinom measuring 5mm in diameter in the right paramedian nasal tip and the superior margin of the nasal wing, near the free edge. The tumor was removed, with resection margin of 1mm. It was associated with multiple hyperkeratotic lesions spread across his face. The patient was a farmer with a past history of massive sun exposure. He lived in rural, mountainous and remote regions. The nasal tumor had evolved very slowly and very gradually in volume. The patient underwent surgical excision of BCC with resection margin of 1mm. We reconstructed the loss-of-substance with a very simple small local flap (Zitelli bilobed flap) which allowed to cover the loss of substance and to close it. The recipient healed well after one month-follow-up of local treatment and dressings. The patient underwent the removal of the sutures on day 10, then he underwent fat dressings with cortisone cream every other day over a period of 15 days.