ABSTRACT
Reconstruction of surgical defects of the nose, particularly the lower one third, is often challenging. The skin of this area is less mobile and fixed on lower structures without a subcutaneous fatty layer. Thus, dissection of tissues is rather difficult and more bleeding can occur during dissection. Furthermore, flap surgery will fail if the flap extends too far. Local flap surgery is one of the more useful techniques that maintains the function and aesthetics of a normal nose. Among these, the nasalis muscle is relatively easy and provides better outcomes. More importantly, vascular supplies from the underlying muscular structure provide greater viability. Additional movement can be achieved by either dissecting under the transverse nasalis or by dividing the transverse nasalis beyond the midline. We report 5 cases of nasalis island pedicle flaps using nasalis muscles. The final results were relatively satisfactory for both functional and cosmetic aspects.