Nasal Reconstruction

Nasal reconstruction has played an important part in the history of plastic surgery given the unique challenges of reconstructing its complex three-dimensional anatomy consisting of a very thin vascular internal lining that is tightly adherent to a thin flexible cartilaginous structure, with an overlying soft tissue envelope consisting of the superficial musculoaponeurotic system, dermis, and epidermis. Preoperative evaluation is critical in nasal reconstruction in order to assess nasal subunit involvement, need for structural grafting, and internal lining defects. Given the psychological impacts of nasal deformities, and the often times staged procedures required to obtain optimal cosmetic and function results, patient preparation is of the utmost importance. In this chapter, we will discuss reconstructive considerations and options for nasal defects ranging from small superficial defects to total nasal defects.