Summary
The anatomy and aesthetics of the nose never change and are similar for cosmetic and
reconstructive rhinoplasty. The disciplines differ in the cause of injury, which determines
the site and degree of damage, the subsequent deformity, and the therapeutic approach
to repair.
The cosmetic surgeon modifies the bony-cartilaginous framework to support and mould
the overlying skin. A thick, scarred or large skin envelope may limit the expected
result but cannot be altered.
When severe scarring or necrosis occurs after a cosmetic rhinoplasty or filler injection,
missing external skin and internal lining become a controlling factor in achieving
nasal shape and must be replaced in exact dimension and border outline, guided by
the principles of aesthetic nasal reconstruction.
This paper illustrates the use of a 3 stage forehead flap and anatomic reconstruction
of the tip cartilages to repair a full thickness necrosis of the tip after a cosmetic
filler injection. An overview of presentation and treatment of this complication is
presented with reconstructive guidelines to direct the surgeon to successful repair.
Keywords
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Article info
Publication history
Published online: May 03, 2012
Accepted:
April 9,
2012
Received:
March 31,
2012
Identification
Copyright
© 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
