Nasal Reconstruction

Nasal reconstruction is a surgery that is meant to restore any defects in the nose. These defects can come from a variety of things: trauma, birth defects, or even removal of cancer. A defect can be a small skin blemish on the nose, or it could be a total loss of the nose for various reasons. Often these things cannot be hidden easily, either with clothing or with makeup.

There are various ways to have a nasal reconstruction done. These will be discussed later, but they all have the same goal: to restore a normal appearance to the satisfaction of the patient. The nose is one of the main facial features that define personal appearance. Aside from providing a means for breathing, the appearance of the nose is important for looking normal to the outside world.

Why Have a Nasal Reconstruction?

As noted above, nasal reconstruction is often used to help restore a normal appearance to the face of the patient. Whether the deformity came from a cancer removal, a traumatic event, or a birth defect, nasal reconstruction can help restore the deformity to more closely approximate normal.

Another reason someone may require a nasal reconstruction is for cocaine nose. Cocaine, as many users and addicts know, can be easily snorted through the nose. However, this comes at a big cost to the inner tissues of the nose that come into contact with the snorted cocaine. Cocaine causes constriction of blood vessels depriving the tissues of nutrients and oxygen. As cocaine usage becomes chronic, the tissues supplied by the constricted blood vessels will eventually die, creating sores inside the nose, perforations of the nasal septum, and scarring. The result is the gradual collapse of the nose and deformity. The process can be deceiving, as the outside skin of the nose may look perfectly normal, while the inside lining and cartilage tissues of the nose are dying and melting away.

Cancers can and do appear on the nose and their removal may result in significant deformity requiring reconstruction. Often, this decision is made after the surgery to remove the tumor or cancer.

Nasal Reconstruction Procedure

Reconstructive surgery of the nose often includes the replacement of the skin and deeper tissues that are not healthy anymore. The nose is composed of layers of tissue. In general, there is the skin layer, the cartilage layer (which provides shape and support), and a lining layer. The type of reconstructive procedure performed is determined by the extent of involvement of the different tissue layers of the nose. During the initial consultation, Dr. Walton will perform a careful examination and determine the safest and most appropriate type of reconstruction to treat the nasal defect.

A common procedure to replace missing skin tissues is called skin grafting. This involves the transfer of skin from another area to replace the skin missing from the nasal defect. The site from where the skin is taken is generally somewhere on the face as this provides the best color match to nasal skin. Common donor areas include the nose itself, the forehead, or the cheek areas. Larger defects involving the deeper nose layers including skin, cartilage, and lining are more complex and may require the use of flaps of tissue from the forehead or cheek. These complex defects frequently will necessitate the use of cartilage grafts from the ear or ribs. In rare cases, the transfer of tissues from other body sites may be required to restore missing nasal lining tissues. These procedures require delicate microsurgery to connect the blood vessels of the face to the tissues to restore circulation. Dr. Walton has extensive experience in reconstructive microsurgery for nose reconstruction.

Are You A Candidate?

The easiest way to determine this is to arrange a consultation with Dr. Walton. In general, patients of all ages are potential candidates for nasal reconstruction provided they are in good health and can undergo an operative procedure with minimal risk. Good candidates for nasal reconstruction include patients who have suffered trauma to the nose, patients with a nasal deformity resulting from cancer removal, or those with birth defects that have resulted in nasal deformity. Patients having serious concerns from a past surgery of the nose are also good candidates for nasal reconstructive surgery.

Nasal Reconstruction FAQs

What is the length of nasal reconstructive surgery?

The length of nasal reconstruction surgery can vary considerably depending on the severity of the deformity and the steps needed to complete the reconstruction. The shortest operations may last only 45 minutes, but some procedures can take up to several hours or longer. Some nasal deformities may require several operations staged several months apart. These reconstructions usually involve a complex transfer of tissues, bone or cartilage grafting, and remodeling of the tissues to achieve a final result.

What can I expect after the procedure?

This varies widely depending on the complexity of the surgery. After the procedure, you should expect swelling, bruising, and some level of discomfort, although nasal surgery is generally not associated with excessive pain. You will be given instructions to sleep with your head elevated above the level of your heart for two weeks following surgery to minimize swelling. High fiber foods will prevent constipation, which causes strain. Smiling and laughing may hurt after the surgery. Dr. Walton will cover these issues in detail during your office visit.

Are there risks?

With any surgery, there are risks. With nasal reconstruction, the most common risks are infection and residual nasal deformity. Other risks include failure of grafted tissues to “take” to the nasal site and this may require additional surgery to correct.

How soon can I return to work?

This depends on what kind of job you have. For appearance-based jobs (models, movies, etc.), it is suggested to get the surgery done three months before you must be camera ready. If your job doesn’t require a lot of physical activity and you don’t mind being seen with bruising, returning a week after the surgery is usually okay. For physically demanding jobs, at least two weeks is recommended. if you cannot take two weeks from work and have a physically demanding job, ask to do something with desk work instead for a week or two. Dr. Walton’s office can assist you with selected work restriction requests for the post-operative recovery period.

Next Step

For an appointment, please call Chicago Plastic Surgery, LLC office at 312-337-7795, or contact Dr. Walton by filling out our online form. We look forward to meeting you and helping you achieve your nasal reconstruction procedure here in Chicago.