Nasal reconstruction

Result of 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

Links

Related articles

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

References

• MĚŠŤÁK, Jan. Úvod do plastické chirurgie. 1. edition. Praha : Univerzita Karlova v Praze - Nakladatelství Karolinum, 2005. ISBN 80-246-1150-3.