Nasal Reconstruction

  • Yen-Chang Hsiao
  • Cheng-I Yen
Part of the Head and Neck Cancer Clinics book series (HNCC)


The nose is a psychologically significant structure over the central face with intricate functional and aesthetic qualities that can be considerably challenging to reconstruct. Unique contours and shadows of the nasal dorsum are found nowhere else on the body; full-thickness defects must be rebuilt from scratch.

Nasal reconstruction has passed through the stages of cover, lining, and support. Achieving consummation of each stage is based on precise diagnosis and sophisticated surgical design. Visual and artistic ideas are always keys to influence optimal results.

Forehead flaps are acknowledged as the best tool to resurface nasal defects. Also, folded microvascular ulnar forearm flaps have provided reliable and strong nasal foundations. Combination of the above methods can restore the missing tissue for the composite defects in total or subtotal nasal reconstruction.

Nasal cartilage framework has to be stable and solid in order to hold the surfacing flap and protect the nose from postoperative nasal collapse of the dorsum or the vaults. The chimeric autologous costal cartilage onlay graft has been developed to prevent warping.

In terms of enhancement of aesthetic outcome at donor site in forehead flap reconstruction, preoperative botulinum toxin injection is proposed.

Based on Chang Gung Memorial Hospital experiences, some innovative refinements are proposed in order to achieve optimal, functional, and aesthetic results in nasal reconstruction.


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Copyright information

© The Author(s) 2019

Authors and Affiliations

  • Yen-Chang Hsiao
    • 1
  • Cheng-I Yen
    • 1
  1. 1.Department of Plastic and Reconstructive SurgeryChang Gung Memorial Hospital, College of Medicine, Chang Gung UniversityTaoyuanTaiwan

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