Various Methods of Reconstruction in Nasal Defect

코 결손 부위에 따른 다양한 재건

  • Kim, Seok Kwun (Department of Plastic and Reconstructive Surgery, College of Medicine, Dong-A University) ;
  • Yang, Jin Il (Department of Plastic and Reconstructive Surgery, College of Medicine, Dong-A University) ;
  • Kwon, Yong Seok (Department of Plastic and Reconstructive Surgery, College of Medicine, Dong-A University) ;
  • Lee, Keun Cheol (Department of Plastic and Reconstructive Surgery, College of Medicine, Dong-A University)
  • 김석권 (동아대학교 의과대학 성형외과학교실) ;
  • 양진일 (동아대학교 의과대학 성형외과학교실) ;
  • 권용석 (동아대학교 의과대학 성형외과학교실) ;
  • 이근철 (동아대학교 의과대학 성형외과학교실)
  • Received : 2010.02.16
  • Accepted : 2010.03.30
  • Published : 2010.04.10


Purpose: Nasal defect can be caused by excision of tumor, trauma, inflammation from foreign body reaction. Nose is located in the middle of face and protruded, reconstruction should be done in harmony with size, shape, color, and textures. We report various methods of nasal reconstruction using local flaps. Methods: From March 1998 to July 2008, 36 patients were operated to reconstruct the nasal defects. Causes of the nasal defects were tumor (18 cases), trauma (11 cases), inflammation from foreign body reaction (5 cases) and congenital malformation (2 cases). The sites of the defects were ala (22 cases), nasal tip (8 cases) and dorsum (6 cases). The thickness of the defects was skin only (5 cases), dermis and cartilagenous layer (7 cases) and full-thickness (24 cases). According to the sites and thickness of the defects, various local flaps were used. Most of alar defects were covered by nasolabial flaps or bilobed flaps and the majority of dorsal and tip defects were covered by paramedian forehead flaps. Small defects below $0.25 cm^2$ were covered with composite graft or full-thickness skin graft. Results: The follow-up period was 14 months. Partial flap necrosis was observed in a case, and one case of infection was reported, it was improved by wound revision and antibiotics. Nasal reconstruction with various local flaps could provide satisfactory results in terms of color and texture match. Conclusion: The important factors of nasal reconstruction are the shape of reconstructed nose, color, and texture. Nasolabial flap is appropriate method for alar or columellar reconstruction and nasolabial island flap is suitable for tip defect. The defect located lateral wall could be reconstructed with bilobed flap for natural color and texture. Skin graft should be considered when the defect could not afford to be covered by adjacent local flap. And entire nasal defect or large defect could be reconstructed by paramedian forehead flap.


Supported by : 동아대학교


  1. Brian S: Repair of small nasal defects. Otolaryngol Clin N Am 40: 337, 2007
  2. Choe J, Park BY, Lee YH: Nasal reconstruction with skin flap. J Korean Soc Plast Reconstr Surg 8: 375, 1981
  3. Kwon HJ, Yu DS, Kim JW: Hinged turnover flap for reconstruction of nasal ala defect. Korean J Dermatol 44: 593, 2006
  4. Mureau MA, Moolenburgh SE, Levendag PC, Hofer SO: Aesthetic and functional outcome following nasal reconstruction. Plast Reconstr Surg 120: 1217, 2007
  5. Thornton JF, Weathers WM: Nasolabial flap for nasal tip reconstruction. Plast Reconstr Surg 122: 775, 2008
  6. Howard BK, Rohrich RJ: Understanding the nasal airway: principles and practice. Plast Reconstr Surg 109: 1128, 2002
  7. Oh CK, Jang BS, Kim MB, Jang HS, Kwon KS: Reconstruction with bilobed flap after Mohs surgery of basal cell carcinoma on nose. Korean J Dermatol 40: 1064, 2002
  8. Taghinia AH, Pribaz JJ: Complex nasal reconstruction. Plast Reconstr Surg 121: 15e, 2008
  9. Yoon CH, Rhee KR, Oh CH, Kim SH, Min DH: Nasal reconstruction by scalping flap. J Korean Soc Plast Reconstr Surg 9: 89, 1982
  10. Washio H: Retroauricular temporal flap. Plast Reconstr Surg 43: 162, 1969
  11. Hauben DJ, Sagi A: A simple method for alar rim reconstruction. Plast Reconstr Surg 80: 839, 1987
  12. Oh SH, Chung S, Park BY: Case report: Geometrical design of bilobed flap for nasal reconstruction (5 cases). J Korean Soc Plast Reconstr Surg 6: 1140, 1998
  13. Lee KC, Kwon YS, Jung KH, Han JJ, Park JM, Kim SK: Forehead island flap for nasal reconstruction. J Korean Soc Plast Reconstr Surg 32: 199, 2005