Abstract
When the nose is missing, most patients would like to have their normal appearance
and function restored. Unfortunately, the wound does not reflect the true tissue loss
and the available donor tissues are not similar to nasal tissues. So subunit principles
are applied and donor tissues modified to achieve a satisfactory result. All major
reconstructions will require a late revision to revise scars, improve asymmetry, or
open the airway. However, when cover and lining are grossly deficient, the repair
must be totally redone with a second regional flap. Success requires a thoughtful
preoperative analysis and careful reconstructive plan. Small nasal defects may be
resurfaced in two stages with a forehead flap but large deep defects are best repaired
in three stages with an intermediate operation which allows the placement of primary
and delayed primary cartilage grafts, soft tissue sculpting, and folded flap lining
replacements with safety.
Keywords
nasal reconstruction - forehead flap - lining flap - primary and delayed primary cartilage
grafts - revision
