Nose Reconstruction

Nasal defects reconstruction represents a unique set of challenges for the reconstructive surgeon, given the functional and aesthetic significance of the nose. The defect’s characteristics (including size, location, and depth), the number of subunits involved, comorbid patient factors, and patient’s needs are the factors which determine the indicated method of reconstruction. Several techniques are available for soft tissue cover—including healing by secondary intention, full-thickness skin grafts (FTSGs), bilobed flaps, glabellar flap, paramedian forehead flaps, and microvascular flaps—for lining reconstruction (including FTSGs, septal mucoperichondrial flap), and for structural framework reconstruction (including split calvarial bone grafts, conchal, and/or septal cartilage grafts). A combination of these aforementioned techniques is currently used to reconstruct nearly any nasal defect. The aim of this book chapter is to analyze principles and planning of reconstruction, along with descriptions of the most common techniques which are currently employed in nasal reconstruction.