Download PDF
Facial Plast Surg 2014; 30(03): 342-356
DOI: 10.1055/s-0034-1376878
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Revising or Redoing an Imperfect or Failed Nasal Reconstruction

Frederick J. Menick
1   Department of Plastic Surgery, St. Joseph's Hospital, Tucson, Arizona
› Author Affiliations
Further Information

Publication History

Publication Date:
11 June 2014 (online)

    Permissions and Reprints

Abstract

Almost all major nasal reconstructions will require a late revision to refine aesthetics and function. The early surgical result after pedicle division will be determined by the materials, methods, priorities, planning, and surgical stages chosen by the surgeon. Imperfections in nasal contour, including recreation of the alar crease and nasolabial fold, are corrected by soft tissue debulking and secondary cartilage grafting through peripheral or direct incisions. The nostrils are enlarged by soft tissue excision and local tissue rearrangement. Occasionally, the original repair must be discarded and a second regional flap used to "redo" the reconstruction. Success is determined by careful analysis of the visual deformity, regional principles of the subunit reconstruction, and careful planning.

Keywords

nasal revision - nasal redo - failed nasal reconstruction - late forehead flap revision
 

  • References

  • 1 Millard D. Principalization of Plastic Surgery. Boston, MA: Little Brown; 1986
    Google Scholar
  • 2 Gillies H, Millard DR. The Principles and Art of Plastic Surgery. Boston, MA: Little Brown; 1957
    Google Scholar
  • 3 Gillies H. Plastic Surgery of the Face. London: Oxford Medical; 1920
    Google Scholar
  • 4 Burget G, Menick F. Subunit principle in nasal reconstruction. Plast Reconstr Surg 1985; 76: 239
    CrossrefPubMedGoogle Scholar
  • 5 Burget G, Menick F. Aesthetic Reconstruction of the Nose. St. Louis, MO: Mosby; 1993
    Google Scholar
  • 6 Menick FJ. A 10-year experience in nasal reconstruction with the three-stage forehead flap. Plast Reconstr Surg 2002; 109 (6) 1839-1855 , discussion 1856–1861
    CrossrefPubMedGoogle Scholar
  • 7 Menick FJ. An approach to the late revision of a failed nasal reconstruction. Plast Reconstr Surg 2012; 129 (1) 92e-103e
    CrossrefPubMedGoogle Scholar
  • 8 Menick F. Nasal Reconstruction: Art and Practice. Philadelphia, PA: Elsevier; 2008
    Google Scholar
  • 9 Menick F. The modified folded forehead flap for nasal lining–the Menick method in reconstructive surgery and oncology for surgical oncology. Semin J Surg Oncol 2006; 94: 509
    PubMedGoogle Scholar
  • 10 Menick FJ. The evolution of lining in nasal reconstruction. Clin Plast Surg 2009; 36 (3) 421-441
    CrossrefPubMedGoogle Scholar
  • 11 Menick FJ, Salibian A. Microvascular repair of heminasal, subtotal, and total nasal defects with a folded radial forearm flap and a full-thickness forehead flap. Plast Reconstr Surg 2011; 127 (2) 637-651
    CrossrefPubMedGoogle Scholar