The Peng flap was originally described in 1987 as a viable option for re-creation of the convexity of the dorsum and nasal tip in a one step.Defects extending into the Accent Bench sidewall can result in multi-stage procedures.Beustes-Stefanelli in 2015 published a midline-based nasolabial transposition flap utilizing a single-stage repair for large defects of the nasal tip.
There is minimal literature on large nasal tip defects repaired in a single stage and few modifications to the Peng flap.In this case, the Votives sidewall involvement on top of the extent of nasal tissue removed limits the various different methods.