Structural Support Open image in new window

  • Sam Naficy
  • Shan R. Baker


The contour of facial features reflects the shape of the underlying framework of the soft and hard tissue architecture. Thus, it is the skeletal support and soft-tissue coverage that must be meticulously restored for accurate three-dimensional volumetric restorations in order to achieve the ideal result. For the nose, this is facilitated by using cover and lining replacements that are thin and vascular so they will nourish and conform to structural and restorative framework grafts. The goal of nasal reconstruction is to replace missing segments with autologous tissue of similar nature. The tissue should display the same configuration, size, and structural support as the missing nasal tissue. There are a number of available donor sites for obtaining grafts used to provide support integrity to the nose (Table 5.1). Grafts must have sufficient intrinsic strength to maintain the contour of the constructed portion of the nose. Whenever possible, grafts are selected that have an intrinsic shape and contour similar to those of the missing portion of the nasal framework. This reduces the need for graft contouring and bending that may ultimately compromise support integrity.


Septal Cartilage Lateral Cartilage Alar Cartilage Spreader Graft Auricular Cartilage 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Menick FJ. Defects of the nose, lip and cheek: rebuilding the composite defect. Plast Reconstr Surg. 2007;120:887.PubMedCrossRefGoogle Scholar
  2. 2.
    Sheen JH. Sheen A: Aesthetic Rhinoplasty. 2nd ed. St. Louis: Quality Medical Publishing; 1987.Google Scholar
  3. 3.
    Johnson CJ, Toriumi DM. Open Structure Rhinoplasty. Philadelphia: W.B. Saunders; 1990.Google Scholar
  4. 4.
    Peck GC. The onlay graft for nasal tip projection. Plastic Reconstr Surg. 1983;79:27.Google Scholar
  5. 5.
    Baker SR. Interpolated paramedian forehead flaps. In: Baker SR, ed. Local Flaps in Facial Reconstruction. 2nd ed. Philadelphia: Elsevier; 2007:302-306.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.University of Michigan School of MedicineAnn ArborUSA

Personalised recommendations