Reconstruction of the Nose: Diverse Problems and Alternate Solutions

Abstract

Background: The nose is the most prominent and defining feature of the face. Nasal reconstruction for a congenital or acquired defect is one of the most frequent and as well as the most challenging referral for the plastic surgeons as any asymmetry or irregularity in the nasal contour is readily noticeable. Methods: In this case series, the authors present five different case illustrations of nasal defects and deformity involving lower third of nose with increasing complexity, and an overview of various surgical techniques applied for reconstruction of these nasal defects. Results: Nose being a three-dimensional structure, nasal reconstruction occupies a unique position in facial plastic surgery. Loss of any of the structurally essential layers of the nose (skin, cartilaginous framework, inner lining) must be reconstructed following the principles of aesthetic surgery. For complex defects, minor surgical revisions should be anticipated to achieve the best cosmetic outcome. Conclusion: Nasal reconstruction is a highly specialized surgery, and the operating surgeon must be well versed in this area. From the outset, a well-tailored and meticulous planning is of paramount importance to achieve good aesthetic and functional results. However, both the surgeon and patient should allow for flexibility and need for additional procedures, if necessary.