Aesthetic Reconstruction of the Nose

Aesthetic reconstruction of the nose following skin cancer

“…The nasal mucosa is richly vascularized, very compliant, and ideally suited to nourish cartilage grafts. Burget [3] has demonstrated that a bipedicle mucosal flap based on the septum and nasal sidewall can reliably supply excellent lining in many nasal defects. Remnants of the lower lateral cartilage may be included with the flap, but may not provide necessary rigidity without additional cartilage grafts.…”

“…In these rare instances, midline support must be established with a cantilevered bone or cartilage graft. Given this scenario, a thin free flap may be the best choice for lining [7]. Its bulk may impinge on the nasal airway, but a more elegant solution may not be readily available.…”

“…Skin grafts tend to develop a flat surface as healing progresses, and therefore work best for the upper two thirds of the nose, where the nasal skin is thinner and contours are flatter [7]. Small areas of exposed cartilage usually will not interfere with graft survival, because the graft will revascularize from tissue peripheral to the cartilage.…”

“…The bilobed flap can provide good skin cover in a wide range of partial-thickness defects of the nose [7,14]. Because it uses nasal skin, it provides the best possible color match for acceptable-sized defects.…”

Extended Nasolabial Flap for Reconstruction of a Complex Nasal Tip and Columella Defect in an Elderly Polymorbid Patient

“…5,6 Until date, the use of the extended nasolabial flap has only been reported for the treatment of intraoral defects caused after oral submucous fibrosis excision. 7,8 In this article, we report the case of an elder patient with a complex nasal defect affecting the nasal tip, columella and both alas, after basal cell carcinoma excision, which was successfully covered with an extended nasolabial flap.…”