The nose is a very complex structure that has functional and aesthetic implications. It is made up of an external covering (skin), a structure (cartilage) and an internal covering (mucosa). Its restoration has become such a surgical challenge that only experts can offer good results after the procedure.
Skin cancer is the most frequent of cancers in humans, and 25 percent of these tumors affect the nose, so nasal reconstruction surgery is a very common procedure.
The nasal reconstruction is divided into:
- Repair of minor defects: Those defects smaller than 1.5 cm and for which local flaps can be made (taken from the skin next to the defect to cover it).
- Major nose reconstruction: It must be done under the concept of reconstruction by aesthetic subunits, and includes mobilizing tissues far from the defect. It also involves the repair of the affected structures that may be the skin, cartilage or internal covering. To replace the skin, the most used flap is the frontal flap, which is a procedure that is done in two stages; in the first one, the tissue is worn from the forehead to the nose and left joined by a skin bridge that has the artery that feeds the flap; in the second, after 20 days, this bridge is released to obtain the final result. To replace the cartilage the nasal septum, the auricular cartilage or the ribs are used.
Anesthesia
- Local flaps are implanted with local anesthesia.
- For the frontal flap, the first surgery should be performed under general anesthesia, while the release, with local anesthesia.
Postoperative
For the procedure with frontal flaps the patient must take into account the following:
- The procedure leaves an average disability of 30 days.
- A second procedure is required after 20 days for the release of the pedicle.
- Healing must be done on the front part for approximately one month.
- Normally requires more procedures to obtain the final result. These can be done after three months of the first surgery.
- The frontal scar leaves a good result with minimal aesthetic sequelae.
