Modified Rintala flap for nasal dorsum reconstruction: a case report

Introduction andimportance: The Rintala flap is a single-stage option for nasal tip reconstruction, but adequate advancement may occasionally require proximal Burow triangles. We describe a modification of the distal flap margin, using a broad, concave design intended to facilitate advancement and potentially avoid proximal Burow triangles. Presentation of the case: A 70-year-old man underwent excision of a basal cell carcinoma of the nasal tip followed by reconstruction with a modified Rintala flap. The conventional distal margin was replaced with a broad concave design, thereby allowing greater advancement of the distal flap corners and increasing the effective flap length without the need for proximal Burow triangles in this case. A mild initial increase in nasal tip projection was observed as a secondary effect. Histopathology confirmed complete excision with tumor-free margins. The postoperative course was uneventful, with no flap-related complications or recurrence. At 3 months, healing was satisfactory and the nasal tip had a natural contour. Clinical discussion: The modification alters only the distal geometry of the flap and preserves the principles, vascular reliability, and technical simplicity of the classic Rintala flap. By facilitating distal advancement, it may reduce the need for proximal Burow triangles in selected cases. The observed initial overprojection likely reflects tissue redistribution during flap inset rather than the primary aim of the technique. Conclusion: This simple and reproducible modification may represent a useful refinement for selected nasal tip reconstructions. Further clinical experience is required to assess its reproducibility and long-term aesthetic outcomes.