Nasal reconstruction is a broad term to describe complex surgeries of the nose to repair and reconstruct the nose in form and function after trauma or after tumor removal. The surgery is typically performed when there are asymmetries or defects of the nose. The complexity of the surgery depends on how extensive the defect is and what aspects of the nose require reconstruction. The reconstruction can involve all three layers of the nose: nasal lining, cartilage framework, and nasal skin.
Nasal reconstruction can also be useful to treat:
- A skin defect of the nasal bridge or nasal dorsum
- A skin or full thickness defect of the middle portion of the nasal dorsum or nasal sidewall
- Missing or absent nostrils
- Abnormally shaped or absent nasal tip
If you have an asymmetry of the nose from trauma or skin cancer removal, you may be a candidate for nasal reconstruction. If you are unhappy with the way your nose looks after a previous nasal surgery and still have asymmetries, nasal reconstruction may be an option for you.
Patients who have had skin cancer of the nose removed with Mohs surgery are good candidates for nasal reconstruction. Open wounds of the nose can be reconstructed with local tissue of the nose or regional tissue from the cheek or forehead.
Any medical center or practice you choose should be willing to sit down with you and take the time to explain all aspects of the procedure beforehand, including associated risks and recovery. At the Plastic Surgery Clinic of Chicago, we thoroughly review your medical history, speak with you about your expectations, and provide you with an extensive overview of the nasal defect or asymmetry and how we will be performing the nasal reconstruction.
In most cases, nasal reconstruction after Mohs surgery for skin cancer can be performed in the office with local anesthesia. When the defect is small, local tissue and flaps can be used to reconstruct the nose. When defects are larger, the procedure may have to be performed in the operating room with general anesthesia or sedation in order to ensure safety and comfort during the procedure. If the defect is small, the hole may be closed primarily or sutured together. If the defect is too large to be closed together primarily, local tissue nearby can be used to close the defect. At time, cartilage from the ear has to be used to support the nose during the reconstruction. If the defect is large, tissue from the cheek or forehead may have to be used close or reconstruct the nose, for example cheek flaps or forehead flaps. Once the flaps are thinned and contoured, they are rotated to close the hole and sutures are placed to close the incisions. Incision lines are strategically placed to be hidden in shadow lines of the nose so that scars are not prominent.
If the reconstruction is performed in the office with local anesthesia, the recovery is relatively quick. Immediately after the procedure, the patient is able to go home. If the procedure has to be performed in an operating room under sedation or general anesthesia, the recovery is longer. Patients are required to remain at the surgical facility until anesthesia wears off. It is also necessary to have another adult bring you home after a the nasal reconstruction procedure.
Recovery on the day of surgery should involve lying in a comfortable position, a lot of rest, liquids, soft foods, and prescribed medications. Immediately after surgery, the nose and the area under the eyes will typically be swollen and bruised. The swelling will go down within a few weeks. Patients should avoid any strenuous physical activity right after surgery, as it can increase the risk of bleeding and inhibit healing.
It is very important to follow all instructions issued by the plastic surgeon and to attend follow-up appointments so that your doctor can check your healing progress and let you know when it is safe to return to a normal activity and work schedule.
Patients should be aware that nasal reconstruction, as with any medical procedure, come with potential risks. Each individual should consider both the benefits and known risks before undergoing nasal reconstruction. Such risks may include:
- Altered sensation in affected area
- Nasal asymmetries
Always make sure that the surgeon performing the procedure is board-certified by the American Board of Plastic Surgery, and that the surgery is being carried out in an accredited surgical facility.
The cost of this type of procedure is going to fluctuate based on location, surgeon, center, and the individual patient’s needs. Nasal reconstruction is usually covered by medical insurance, but be sure to contact your health insurance carrier to verify your benefits prior to your consultation.
The Plastic Surgery Clinic of Chicago welcomes any questions from both potential patients and returning patients regarding any of the procedures that we offer. We are committed not only to excellent patient care, but thorough patient education; our professional staff will answer any questions you have and ensure that you understand every step of the process. If you’re interested in looking and feeling like the best version of yourself, call us today for a consultation.
All surgical procedures by the Plastic Surgery Clinic of Chicago are performed at top hospitals in Chicago and CMS or AAAASF-certified surgical centers for safety.