Patients whose nose has been destroyed by a tumor or injury carry a severe psychological and social burden. Esthetic reconstruction ranges among the most challenging tasks in plastic surgery. Helmut Fischer and Wolfgang Gubisch present the different options for nasal reconstruction surgery in the current issue of Deutsches Arzteblatt International (Dtsch Arztebl Int 2008; 105[43]:741-6).
The authors present the case of a woman who had had a tumor removed from the tip of her nose 12 years previously. The tumor recurred and destroyed the woman's nose almost completely over the following 7 years. The hope is that patients will not have to suffer this kind of trauma in the future. New operative techniques in plastic surgery enable surgeons to treat large defects after tumor treatment or due to dog bites with a much better cosmetic result. In smaller wounds, the surgeon can do the reconstruction within a single operation. If more than a quarter of the nose has been destroyed, the limitations of this method have been reached: The patient will remain disfigured even after surgery. Better esthetic results can be reached by performing several surgical procedures in succession. However, sometimes a satisfactory result can be achieved only by means of amputation and subsequent reconstruction of the severely damaged nose.
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