RECONSTRUCTIVE RHINOPLASTY / NASAL RECONSTRUCTION (Washington DC, Virginia & Chevy Chase Maryland)
The nose is easily susceptible to trauma, dog bites, injury and skin cancer. While damage to the underlying bone and cartilage can be repaired through a Septo-Rhinoplasty, missing or damaged skin needs to be repaired as well if indicated. Small defects on the nose tip can be repaired by full thickness skin grafts but all other locations on the nose and all larger defects require flaps for reconstruction. Some commonly used flaps are the bilobed flap, the rhomboid flap, the paramedian forehead flap, the melolabial flap and the sliding glabellar flap. Complete defects may require free tissue flaps such as the radial forearm free flap. Underlying structure – if missing – must also be replaced with ear cartilage or rib cartilage, etc. Internal lining of the nose must also be addressed. Therefore larger nasal defects become an issue of triple layer reconstruction. Dr. Gary C. Burget in Chicago Illinois and Dr. Frederick J. Menick in Tucson Arizona, and Dr. Shan Baker in Livonia Michigan are world famous for large defect nasal reconstructions requiring multiple stage repair.