Abstract
Former nasal reconstruction techniques were limited to skin coverage and to the middle part of the nasal framework. Unfortunately, the results were not stable in time, secondary distortions and scarring of the reconstructed nose occurred.
Modern techniques are based on the complex reconstruction of all the nose layers, especially the reconstruction of the inner mucosal lining, where the septal flaps are commonly used. Supporting layer of the nose is completely reconstructed using the cartilage or even the bone graft is applied in the dorsal part.
Local flaps are used for nasal surface reconstruction because of their vascularity, color and texture. The paramedian forehead flap in its three-stage modification is considered as an ideal solution for larger nose defects.
In case the defect impacts more than 50% of the size of the aesthetic nasal subunit, the entire subunit is replaced. Although the overall length of the reconstruction is longer and the number of necessary treatments has increased, the good aesthetic and functional result of a nose reconstruction, that are stable over time, are achieved when above mentioned principles are followed.