A practical approach to nasal reconstruction in Asian patients

Abstract

Background: The study aimed to evaluate nasal reconstruction techniques customized for Asians. The currently available nasal reconstruction guidelines are based on Caucasian patients, and their applicability is limited in Asian patients due to differences in anatomical and structural features.Methods: A retrospective analysis was performed of the medical records of 76 patients who underwent nasal reconstruction at a single center between January 2010 and June 2020. A comprehensive evaluation was conducted of patients’ baseline demographics and clinical characteristics, including age, sex, medical history, defect size and location, reconstructive procedure, pathological diagnosis, postoperative complications, and recurrence.Results: In 59 cases (77%), nasal defects resulted from tumor ablation, and the remaining 17 cases involved post-traumatic (20%) and infection-induced (3%) tissue damage. The most common defect location was the alae, followed by the sidewalls, tip, and dorsum. Forehead flaps were the most commonly used reconstructive technique, followed by nasolabial advancement flaps, rotation flaps, and skin grafts. Each procedure was applied considering aspects of structural anatomy and healing physiology specific to Asians. Complications included nasal deformity, hypertrophic scarring, secondary infection, and partial flap necrosis, but no cases required additional surgical procedures. Tumors recurred in two cases, but tumor recurrence did not significantly affect flap integrity.Conclusion: Nasal reconstruction techniques applied considering Asians’ facial features resulted in fewer postoperative complications and higher patient satisfaction than the approaches that are currently in widespread use. Therefore, this study is expected to serve as an essential reference for establishing treatment guidelines for nasal reconstruction in Asians.

Single-stage acellular dermal matrix reconstruction of defects in the nose and ears with exposed cartilage: a prospective case series

“…In this report, we describe a simple approach that achieved high patient satisfaction, required less operative time, and led to no recurrences. The locoregional flap was used in these defects in Asians in a previous study and had the same healing time and satisfaction results [ 10 ]. Healing took approximately 3–4 weeks in our report, whereas it could take more than 6–8 weeks with the traditional two-stage forehead flap or two-stage reconstruction with an acellular dermal matrix [ 1 , 6 , 21 ].…”

“…Due to skin phototypes, Asians are prone to hyperpigmentation, hypertrophic scars, and keloids after reconstruction. In practice, primary closure is chosen when the defect is minor (≤ 1 cm) or the patient is old and does not care about the aesthetic result [ 10 , 11 ].…”

“…Single-stage reconstruction of the ear after excision of tumors also shows good outcomes [ 16 ]. However, Asian are prone to contractures and scars after reconstructions with flaps [ 10 , 11 ].…”

Open rhinoplasty in secondary cleft nose deformity with suture techniques

“…Numerous methods were introduced for the repair of deforsuch as the two V-flaps [9], reverse U-flap [10], compos- The average value of the scores answered in the questionnaire. ite graft [11][12][13], full-thickness skin graft [14], V-Y composite flap [15], and double composite tissue Z-plasty [16]. More often, rib cartilage, conchal cartilage, and silicone implants are commonly used.…”

Efficacy and safety of equine cartilage for rhinoplasty: a multicenter double-blind non-inferiority randomized confirmatory clinical trial

“…A substantial amount of dorsal augmentation is frequently needed for Asian rhinoplasty because the nasal bones are flat, and the radix is relatively low in Asians compared to Caucasians [1][2][3]. Various nasal implants have been used for dorsal augmentation.…”