Nasal Reconstruction

Restoring the form and function of the nose following skin cancer removal or traumatic injury is an important part of healing. Artistic vision, creativity and meticulous attention to detail are required to achieve success.

The University of Kansas Health System provides world-class nasal reconstruction for men and women in the Kansas City region and beyond. We often have people seek consultations for nose reconstruction following a previous attempt at nasal reconstructive surgery, or for corrective rhinoplasty to improve poor results from a previous nose job.

Some of the most frequently suffered fracture injuries involve trauma to the nose and/or mid-face. In addition to altering the nose’s cosmetic appearance, damage to the delicate bones in the nasal structure can cause obstructed breathing, nasal congestion, loss of smell, a deviated septum and other concerns. While not all nasal fractures require reconstructive surgery, the procedure can correct impaired function of the nasal structure and/or improve or restore its appearance.

Skin cancer removal on the nose or face can leave disfiguring scars or a distorted appearance, necessitating the expertise of an experienced surgeon to correct cosmetic deformities. Our specialists offer nasal reconstruction for people with simple or complex cases of nasal malformation to restore a natural appearance to the nose and mid-face as part of skin cancer reconstruction surgery.

Individuals who have suffered a traumatic nasal injury and are having trouble breathing or those who seek to correct the appearance of their nose are generally good candidates for nasal reconstruction. Usually, the sooner a medical consultation takes place after injury, the better the surgical outcome.

In some situations, however, the initial injury may require some time to heal prior to the reconstruction procedure to facilitate skin grafts and other technical procedures. The best results may be achieved in situations in which half of the nose remains unaffected, which serves as a working model for your surgeon to base the nasal reconstruction on the damaged side of the nose. For situations requiring more total nose replacement, pictures may be used to provide an accurate template.

People of all ages may be candidates for nasal reconstruction, though based on the specific case, very young patients may be advised to postpone their procedure until their features have matured slightly.

The nasal reconstruction procedure varies depending on the nature of facial trauma suffered and the surgical goals of each person. Our plastic surgeons, facial plastic surgeons and otolaryngologists employ advanced surgical strategies personalized for each person’s respective needs to achieve an exceptional and natural-looking result.

During your consultation, a treatment plan will be developed to address the cosmetic concerns and functional deficiencies in the nasal structure. Your surgeon will then precisely rebuild the nose cartilage, structural framework and skin tissue to recreate your nasal profile. Depending on your injury, a skin flap or skin graft may be necessary. The procedure is typically performed under general anesthesia.

Depending on your particular needs, nasal reconstructive surgery can:

• Correct damage from a nasal fracture or traumatic injury
• Improve form and function of the nose
• Improve or restore the size, shape and overall appearance of the nasal structure
• Repair a deviated septum or other impaired nasal function
• Restore normal breathing and sense of smell

Nasal reconstruction requires extensive knowledge of facial anatomy and meticulous technique that can be utilized to evaluate the appropriate functional and aesthetic concerns in the nasal structure and correct them with accuracy.

The simplest nose reconstruction surgery is secondary intention healing, in which a small wound on the flat surfaces of the nose may be allowed to heal naturally. This method is avoided for wounds on the nasal tip or nostrils, as it may affect the shape of the nose.

The next-easiest repair is the simple suture closure, in which the sides of the incision are sutured together. This also may only be done on the upper nose, as it can distort the lower nostril and nasal tip areas.

Skin grafts may be performed on larger wounds that require additional tissue or skin for smooth healing. These grafts are taken from other areas of the body and attached to the wound area. Variations of this procedure include the use of local flaps, in which the skin of the nose is lifted, stretched and repositioned to cover the wound area and regional flaps, in which other areas of the nearby face are stretched. Excess skin is removed and the grafted skin is set in place over the wound.

For larger, more complete nose reconstruction surgery, forehead flaps may be used, as well as cartilage grafts from the nasal septum, ear or ribs. Cartilage grafts are necessary for total nasal reconstruction and reconstructions requiring additional support.