The Rintala Advanced Modification (RAM) Flap: A Novel Technique for Off-Centre Nasal Reconstruction.

The traditional Rintala flap is associated with visible forehead scarring and glabellar deformities. We describe the Rintala Advanced Modification (RAM) flap, a novel technique that restricts the flap below the eyebrow line and employs asymmetric Burow's triangles for off-centre defects. Based on 20 patients with nasal basal cell and squamous cell carcinomas, the RAM flap demonstrates superior aesthetic outcomes with no glabellar complications or flap tip necrosis.