Reconstructive RhinoplastyJanuary 20, 2019
After cancer removal surgery or sometimes due to facial trauma, the nose may become disfigured because of the lack of tissue that has been lost or removed. Reconstructive rhinoplasty is a surgical procedure that can help restore tissue that is lost or has been damaged beyond repair.
Surgical repair involves the use of flaps and grafts from various regions of the body to restore the absent component tissues. This is a complex procedure in which patients may need numerous surgeries over several months.
In addition, reconstructive rhinoplasty is a specialized procedure and patients should seek a surgeon with experience in this complex procedure. Board certified plastic surgeon Dr. Gary Motykie MD provides reconstructive rhinoplasty and other procedures to patients in Beverly Hills, West Hollywood, Los Angeles, and surrounding locations.
Mohs surgery is a common reason for nasal reconstruction as it eliminates skin cancer from the nasal tip. The facial cosmetic surgeon will discuss surgical options with the patient to reconstruct their nose including aspects such as using a skin graft, local graft, or a staged procedure like a forehead flap.
The local flap reconstructive procedure uses the skin available on the nose to seal the incision. The patient may be a candidate for a local flap if the wound on their nose is small and can be covered by stretching the skin.
The surgeon will recommend this procedure to be performed a few days following Mohs surgery to enable the skin to start healing and enhance the results of the surgery.
In case the area of missing tissue is too substantial to be addressed with a local flap, the surgeon may relocate skin from another area of the body. At the time of the pre-op consultation, the surgeon will choose the best source for a skin graft.
Similar to a local flap, the patient undergoes reconstructive surgery a few days after the Mohs procedure. A skin graft is undertaken in one stage as an outpatient procedure.
A staged procedure such as a forehead flap is a multi-stage process that starts on the day of the Mohs procedure. The surgeon places an expander beneath the forehead to stretch the skin and develop healthier skin to be used for the nose. When a sufficient new skin is produced, the surgeon uses it to cover the nose and develop as natural an outcome as possible.
Nasal Reconstruction Recovery
After nasal reconstruction, the recovery process is crucial in attaining beautiful and functional outcomes. The surgeon’s office will offer the patient a detailed list of post-op instructions, including:
- Clean the incisions with hydrogen peroxide once daily.
- Apply antibiotic ointments on incisions and within the nostrils two times a day.
- Place cold compresses or frozen peas gently over the eyes and cheeks for the initial three days after the surgery. Three days after the surgery, use warm compresses on sites with persistent bruising.
- Keep the head in raised position for at least one week after the surgery including when sleeping, relaxing, and resting.
- Do not exercise vigorously for three weeks following the surgery.
Cosmetic surgeon Dr. Gary Motykie MD receives patients from Beverly Hills, West Hollywood, Los Angeles, and nearby areas for reconstructive rhinoplasty.
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