Surgical Treatment of Defects on the Tip of the Nose

Abstract

Selection of the best defect repair allows the majority of nasal tip defects to be repaired with excellent functional and cosmetic results.

Complete division of the pedicle of the forehead flap is possible after 1 week of engraftment in selected patients

“…1 Smaller defects can be closed with direct closure or local flaps. [2][3][4][5][6] Larger defects can be a challenge to reconstruct as the stiff tissue of the nose makes it difficult to adequately mobilize the tissue. Skin grafting may be an option for these cases.…”

“…Skin grafting may be an option for these cases. 2,7,8 However, cosmesis may suffer as skin mismatch is a common phenomenon after skin grafting. 2 The forehead flap (FHF) is a well-established alternative, with good cosmesis, especially for reconstructing defects of the lower third of the nose.…”

“…2,7,8 However, cosmesis may suffer as skin mismatch is a common phenomenon after skin grafting. 2 The forehead flap (FHF) is a well-established alternative, with good cosmesis, especially for reconstructing defects of the lower third of the nose. [9][10][11][12][13][14][15][16][17][18] Different modifications of FHF allow it to be applied for a variety of nasal defects, including those that need cartilage grafting or lining of the nasal ala. 9,[16][17][18] It is a safe procedure, with only minor complication rates 19 and can even be used in elderly patients.…”

Columellar Advancement Flap for Midline Nasal Defects

“…Multiple options exist to repair nasal tip defects, including primary closure, bilobe transposition flap, dorsal nasal flap, and full-thickness skin grafting. [2][3][4][5][6] Healing by secondary intention for nasal tip defects is suboptimal. The convex surface leads to poor recontouring and an obvious flat or depressed white scar.…”

Burow's grafts in the facial region

“…If the defect is situated on the upper two thirds of the nose, pre‐auricular skin as a donor site provides an excellent tissue match. For defects on the nasal tip, 10 the conchal bowl or glabella skin 11 can be used for grafting.…”