The reconstruction of the nose may be required for a number of reasons, including trauma, birth defects and damage following surgeries, such as tumor extirpation or the removal of skin lesions. The chief concerns of nasal reconstruction are breathing and the recreation of the nasal appearance as it was before the damage. Some of the surgical procedures that may be utilized include:
- Secondary intention healing
- Simple suture closures
- Skin grafts
- Local flaps
- Regional flaps
- Forehead flaps
- Cartilage grafts
Who should undergo nasal reconstruction?
Patients of all ages may undergo nasal reconstruction, though based on the specific case it may be recommended that very young patients postpone their procedure until their features have matured slightly.
In some situations, the nasal wound may require some time to heal prior to the reconstruction procedure to facilitate skin grafts and other technical procedures. The best results may be achieved in situations in which half of the nose remains unaffected, thereby providing a working model for your physician to base the nasal reconstruction on the damaged side of the nose. For situations requiring more total nose replacement, pictures may be used to provide an accurate template.
What happens during surgery?
The sensitive location of nasal surgery contributes to the use of general anesthetic for most nasal reconstruction surgeries. The simplest nasal repair is secondary intention healing, in which a small wound on the flat surfaces of the nose may be allowed to heal naturally. This method is avoided for wounds on the nasal tip or nostrils, as it may affect the shape of the nose.
The next easiest repair is the simple suture closure, in which the sides of the incision are sutured together, though this also may only be done on the upper nose, as it may distort the lower nostril and nasal tip areas.
Skin grafts may be performed on larger wounds that require additional tissue or skin for smooth healing. These grafts are taken from other areas of the body and attached to the wound area. Variations of this procedure include the use of local flaps, in which the skin of the nose is lifted, stretched and repositioned to cover the wound area, and regional flaps, in which other areas of the nearby face are stretched, excess skin is removed and the harvested skin is set in place over the wound.
For larger, more complete reconstructions, forehead flaps may be used, as well as cartilage grafts from the nasal septum, ear or ribs. Cartilage grafts are necessary for total nasal reconstruction and reconstructions requiring additional support.
What should I expect after surgery?
The recovery for each surgery will vary based on the severity of the specific procedure and the health of the patient. Bandages are applied, and possibly splints for more complete reconstructions involving structural damage.
Swelling and bruising may occur in the first few days, with the bruising diminishing in 5-10 days and the swelling subsiding in 2-4 weeks. Stitches may be removed in about a week, and normal activities resumed in 1-3 weeks depending on the severity of the procedure.
The nose should be protected from accidental impact for a few weeks or months after the surgery. Specific details regarding the recovery procedure, protective equipment, sports performance and a recovery timeline may be given to you before and after your procedure.
Very unlikely complications of this procedure include an asymmetric appearance, infection, bleeding and changes in sensitivity, which may occur at both the nasal reconstruction site and the donor area.
Learn more about nasal reconstruction in Kansas City
If you believe you may be a candidate for nasal reconstruction, please contact us to schedule a consultation in which your concerns and questions will be personally addressed.