Nasal surgical defects resulting from the removal of non-melanoma skin cancer represent a challenge for the surgeon due to the anatomical complexity and the high functional and aesthetic relevance of the region.The purpose of this paper is to demonstrate the jigsaw puzzle advancement flap. Resection of basal cell carcinoma was performed in the patient's perialar region, followed by the reconstruction with the jigsaw puzzle advancement flap, with excellent aesthetic and functional results.The presented technique is useful and not yet widespread, and it should be part of the dermatological surgeon's arsenal in the reconstruction of surgical defects located in the nasal ala-perialar region.

Keywords: Nose; Reconstructive surgical Procedures; Surgical flaps

The reconstruction of deep surgical defects of the nasal tip and wing of the nose often presents a challenge to the surgeon. In these cases, full-thickness skin grafting is widely used, but it often results in sinking or graft depression. We present a surgical technique that is easy to perform and reproducible; nonetheless still very little diffused in Brazil: the “Drumhead” graft. This method performs the grafting of a rigid plastic suspension together with the full-thickness skin graft. Thus, this technique constitutes another tool for the dermatological surgeon to prevent irregularities of undesirable contours, graft depression, and nasal vestibule collapse.

Keywords: Nose; Nose neoplasms; Skin neoplasms; Skin transplantation