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

INTRODUCTION: Non-ablative fractional lasers are well-known effective treatments for skin rejuvenation. However, the high incidence of post-inflammatory hyperpigmentation increases the risk of complications, especially in higher skin phototypes. Caviar phospholipid supplementation has been used successfully to reduce the inflammatory process, which may be beneficial to manage post-inflammatory hyperpigmentation after laser.
OBJECTIVE: To compare the incidence of post-inflammatory hyperpigmentation in high phototypes after caviar phospholipid supplementation.
METHODS: 20 patients underwent a non-ablative fractional laser session (Nd:YAP 1340nm, Zye Vydence, Brazil), and 10 of them used 200 mg of caviar phospholipid orally daily for 15 days before treatment and 40 days after. Patient images were evaluated before and after 40 days of laser application. Clinical assessment was based on the presence or absence of post-inflammatory hyperpigmentation. Statistical analysis was performed using the Z test.
RESULTS: We observed no cases of post-inflammatory hyperpigmentation in the experimental group; however, the control group presented 30%.
CONCLUSIONS: Caviar phospholipid may be an option for preventing post-inflammatory hyperpigmentation after non-ablative fractional lasers, aiming to avoid adverse events.

Keywords: Lasers; Skin; Rejuvenation; Fatty Acids; Omega-3.