Nasal reconstruction

Nose is one of the main aesthetic dominants of the face.
 * loss mostly due to tumor removal / injury
 * aim of reconstruction: to reach the minimal possible difference in color, skin texture and contour

Primary closure

 * for smaller defects, loose suture (the desirable outcome is healing with a fine scar + maintaining the contour)

Skin Graft

 * full-thickness skin graft from the preauricular area (alternatively retroauricular or supraclavicular area)

Full thickness auriclar composite chondrocutaneous graft

 * suitable for reconstructing a nasal wing defect
 * maximum graft size is 2 x 1 cm

Local flaps

 * various modifications of transposition flaps: e.g. double flap, V-Y island flap from the nasolabial fold, dorsal nasal flap
 * forehead flaps ("Indian"): transfer of the tissue needed for reconstruction on the nose + detachment of the flap (with a time gap of several weeks), the donor area is closed with a primary suture / skin graft
 * frontotemporal + retroauricular lobes: less frequent, after tissue transfer to the defect, most of the flap is positioned to its original location

Distant flaps

 * transfer of a pedicle flap from the upper arm (Tagliacozzi 1597) has merely historical significance at this point
 * free transfer of the a. dorsalis pedis osteomyocutaneous pedicle island flap

Tissue expander

 * is not widely applied in nose reconstruction
 * on the inner surface of the nose: skin graft / reverse island flap from the nasolabial fold
 * nasal skeleton reconstruction: septum cartilage, cartilaginous / bone graft from a rib

Related articles

 * Upper lip reconstruction
 * Lower lip reconstruction
 * Facial Reconstruction
 * History of plastic surgery
 * Facial soft tissue injuries