Surgical Repair on the Nose

Rick Lin, DO MPH

The Master Resident Dermatologic Surgeon

Primary closure for midline defects of the nose: A simple approach for reconstruction

ABSTRACTWe present a modification of the standard linear closure for small to medium-sized defects of the lower nose that avoids many of the limitations of flap or graft reconstruction. The surgical technique detailed yields predictable functional and cosmetic reconstruction with very few complications. The dermatologic surgeon should consider this option when reconstructing defects of the lower nose. (J Am Acad Dermatol 2000;43:508–10.)

Post operative result

• “The reconstruction is evaluated 6 weeks postoperatively and dermabraded, if required. Dermabrasion is needed more commonly in patients with highly sebaceous skin. Less than 10% of patients will require any postoperative dermabrasion; occasionally a scalpel is used to tangentially excise or plane the edges before dermabrasion. The dermabrasion is performed with the use of medium-grade aluminum oxide sandpaper and is quick and efficient.”

A dorsal nasal advancement flap for off-midline defects

• Background The repair of nasal tip defects often poses a challenge as many of the commonly used techniques for repair of the distal nose can result in obvious scars, mismatched skin, or distortions of the nasal contour that can compromise the aesthetic outcome.

• Objective Our aim was to create a novel nasal tip flap and examine outcomes of its use

• Methods The dorsal nasal advancement flap was studied in 30 patients.

• Results All patients had good to outstanding results and no complications.

• Conclusion This new flap, a modified Burow's advancement flap adapted to the nasal tip, provides an alternative to full-thickness skin grafts and transposition, rotation, and pedicle flaps for repair of the distal nose that is easy to execute and has optimal aesthetic results. (J Am Acad Dermatol 2004;50:380-3.)

“The most logical method of closure of nasal defects is movement by advancement with the vector of closure oriented perpendicular to the long axis of the nose. “