Background informationNasal reconstruction is the art of reconstructing the nose after injury, cancer, birth defect, or other damage. The foundation of nasal reconstruction lies in the understanding of the functional anatomy of the nose. In general, the nose is like a tent: there is a cover (skin), lining (nasal mucosa), and support (bone and cartilage). The cartilage acts like the tent poles and keeps the skin covering up, which in turn gives the nose its shape and maintains the airway open. The lining of the nose, or nasal mucosa, protects the cartilage on the inside and prevents damage or infection of the cartilage. All three of these parts must be appropriately reconstructed in order for the nose to regain its form and function.
Reconstruction of skin coverThe supportive structures of the nose are covered and protected by the external skin. Because the skin is exposed, it is susceptible to injury and sun damage, which may lead to skin cancer. This is especially common in Los Angeles due to the high sun exposure. After Mohs surgery or injury, there is often skin missing from the nose which must be reconstructed to protect the delicate cartilage underneath. Often, the existing skin on the nose can be rotated or moved to cover any missing. However, depending on the size, location, and shape of the missing skin, it can be necessary to use skin from the forehead, cheek, or as a skin graft to rebuild the skin cover. Sometimes, it may take several procedures to sculpt the skin of the nose into the optimal shape.
Reconstruction of cartilage and bone supportThe support structures of the nose are composed of bone and cartilage. They provide an extremely important part of nasal function as they keep the nose expanded and the airway open, and give the nose its form and appearance. When the cartilage is removed or damaged, the nose is at risk for collapse. In order to prevent this from happening or to reconstruct the nose after collapse, cartilage from the nasal septum, ear, or rib can be used. Sometimes, as in a deviated septum or after trauma to the nasal septum, the nasal septal cartilage becomes warped and protrudes into the airway. In this case, it must be removed or sculpted so that the airway can stay open.
Reconstruction of nasal liningThe lining of the nose is composed of a specialized form of mucosal tissue and protects the bone and cartilage of the nose from exposure, along with other functions. When the nasal lining is damaged or removed, the nasal cartilage becomes exposed is at risk for infection, which can lead to nasal collapse. Reconstruction of the nasal lining is a complicated process because it is very thin and has specialized functions. When there is a small amount of lining that is missing, like in a perforated septum, the existing lining can often be rotated or moved over to replace the part that is missing. However, when there is a large amount of lining that is missing, it can be necessary to use another part of the body, such as the skin of the forearm, to reconstruct the lining. These procedures are very complex, and may take several stages to achieve the desired results.
Dr. Hirsch is well trained in nasal reconstruction and performs reconstructions after skin cancer, cocaine abuse, traumatic damage, as well as total nasal reconstruction. Dr. Hirsch also performs nasal reconstruction for patients who were born with cleft lip and have nasal deformity as well as other congenital nasal abnormalities, and breathing improvement surgery such as septoplasty and turbinate surgery, nasal valve surgery, and correction of nasal septal perforation. Before your appointment with Dr. Hirsch, feel free to browse the information about some common types of nasal reconstruction surgeries that is available below.
- Septoplasty and breathing improvement surgery
- Cocaine nose reconstruction
- Cleft lip nasal deformity reconstruction
- Traumatic nasal reconstruction
- Skin cancer