How it works
Everything begins with a careful consultation. Your surgeon examines your nose inside and out, reviews your history of injury or illness, and assesses the three parts that need to be rebuilt: the outer skin covering, the cartilage and bone framework in the middle, and the mucosal lining inside. This is also the time for you to explain what you hope for and to hear which results are realistic.
Total nasal reconstruction is usually performed under general anesthesia, which means you are fully asleep throughout the operation. Depending on the extent of the damage, your surgeon may take cartilage from your nasal septum, the rim of your ear, or your rib to rebuild the support framework, and may use a skin flap with its own blood supply, often from the forehead, to create the outer covering.
Because all three layers need to be rebuilt at the same time, this surgery is usually divided into several stages. In the first stage, your surgeon places the cartilage framework and moves the skin flap to cover it. After a few weeks for the tissue to grow its own blood supply and heal, a later stage divides the feeding pedicle and refines the shape of the nose. The number of stages and the time between them differs from person to person.
Throughout the process, the team watches the color and vitality of the skin flap closely, because a healthy blood supply is the factor that decides the outcome. You will be shown how to care for the surgical site between stages and which signs to report right away.