Nose Reconstruction After Skin Cancer
Typically if a skin cancer needs to be removed from the nose, that surgery is performed by a dermatologist. However for best cosmetic results, the dermatologist should work in tandem with a plastic surgeon, such as Dr. Sam Rizk.
To remove skin cancer, a dermatologist will perform a MOHS excision. This procedure is a micrographic excision developed to preserve as much normal tissue as possible by examining and mapping surgical borders using a microscope. Nose reconstruction After Skin Cancer should be coordinated with the plastic surgeon ahead of time so that the patient can undergo reconstruction on the same day as the MOHS excision.
Following the excision, Dr. Rizk will determine how to perform the reconstruction. This may involve using a local tissue flap from surrounding tissue of the face, a composite graft composed of skin and cartilage or a forehead flap. If skin and cartilage are required for a graft, these tissues are usually harvested from the patient’s ear. A forehead flap is considered a last resort as it must remain attached to the forehead via a tissue bridge until a blood supply for the new tissue in the nose is established.
A preferred option is the usage of a localized tissue flap. This may take the form of a flap where tissue is rotated into the defect, advanced into the defect or moved into the defect using a combination of rotation and advancement.
When using skin from other parts of the face to reconstruct the nose, the result may create some asymmetry as the skin of the face is thicker than that of the nose. This asymmetry can be corrected after a year has passed since the initial reconstruction by undergoing a cosmetic rhinoplasty or a laser treatment. In this case, the cosmetic rhinoplasty would involve thinning out the thicker tissue that was transferred to the nose. Scars may be decreased though the use of either a fractionated co2 laser, microdermabrasion or both. If scar tissue in the intranasal area is impeding a patient’s breathing, surgery to reduce the bulky tissue can be performed sooner - within less than a year from the initial reconstruction.