Nasal Reconstruction (rebuilding the nose after skin cancer)

Explore nasal reconstruction after basal cell skin cancer, nasal surgery, & sculpture of the nose by Dr. Michael Bermant, MD plastic & cosmetic surgery.

Michael Bermant, MD
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Basal Cell Skin Cancer

Case 1 Extensive recurrent cancer frontal views

Nasal Reconstruction

 The tumor

After final surgery 

1 nasal reconstruction plastic surgery basal cell cancer skin cancer  nasal reconstruction skin cancer (basal cell cancer) postop front

This patient had basal cell cancer previously removed several times in the past by other doctors. He had also received multiple radiation therapy treatments many years ago for the basal cell cancers of the nose and face.

His recurrent basal cell cancer was resected using a modified Mohs' treatment. A new nose was built by using skin from his forehead. There was not enough forehead height for the flap to work without expansion. A skin expander was inserted and inflated up over several weeks. The stretched skin was now ready to rebuild the nose.

Technique

 Skin Expansion

Flap in Place 

nasal reconstrucion forehead skin exansion, skin exander, basal cell cancer, skin cancer  2 nasal reconstruction plastic surgery forehead flap nasal reconstruction

The forehead skin was brought to the nose and attached. After the blood supply became established to the nose, the forehead attachment was divided. The nasal reconstruction below is after flap division and using the forehead tissue to rebuild the nose.

Plastic and reconstructive surgery sometimes needs such staged reconstruction especially when local tissue would not have been enough. Tissue was needed not only for the outer skin, but also the lining. The forehead flap was folded to provide both. The septum was used as another flap for nasal tip support.

Nasal Reconstruction

After surgery 

nasal reconstruction skin cancer (basal cell cancer) postop front

See the lateral views of this case.


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