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New Orleans - For J. Ramsey Mellette, M.D., avoiding pincushioning of nasal flaps taken from the nasolabial fold is difficult. "A certain degree of pincushioning in a flap that is taken from the cheek and put onto the nose is inherent in the flap because it's cheek-on-nose," said Dr. Mellette, professor of dermatology and dermatologic surgery, University of Colorado at Denver's health sciences center, department of dermatology.