Nose Surgery, Northern Virginia

For minor nasal defects (less than 4 to 5 mm) located around the nasal passage opening and columella tissue, or limited only to the upper portion of the nose area, a simple suture closure technique may be used. Only a small amount of extra skin is available on the nose, which limits the size of the defects that can be sutured and closed. If larger defects are closed with limited skin, it can distort the remaining tip or nostrils.

Secondary healing is used for small nasal defects on the concave or flat surfaces of the nose. The surgeon will avoid this treatment approach near the convex tip or alar rim in order to prevent distortion of the nasal tip or nostril margins by scar contraction or the creation of a chopped-off or blunted tip appearance.

Primarily utilized for the treatment of small or superficial nasal defects, a skin graft is frequently taken from the neck, forehead, behind, or in front of the ear. Skin grafts may be employed as a nasal reconstruction repair technique either immediately after the wound has occurred, or a week or two later ("delayed" graft) if the wound needs time to properly vascularize. Although skin grafts may be a suitable option for small wounds, the color and texture of the graft can be unpredictable and may not perfectly match the skin adjacent to the nasal region.

Small nasal defects may be treated with local skin flaps, which redistribute skin from the upper nose's glabella area to cover a defect within the inferior dorsum and tip. Because there is such a small amount of excess nasal skin, local flaps are only appropriate for small (less than 1.5 cm), superficial wounds. Although these procedures do typically result in a small scar, the flap technique offers the benefit of creating a more reliable texture and color match than can be achieved with natural skin grafts, an appealing option for many patients.

Regional flaps reposition excess tissue from facial areas adjacent to the nose (e.g. nasolabial fold, forehead) in order to cover a nasal defect or wound. Nasolabial flap cosmetic reduction via reconstruction of the nose may be performed as a single outpatient procedure, or (for deeper defects) a two-stage nasolabial flap involving two surgeries spaced 3-4 weeks apart.

The skin of the forehead often serves as an excellent donor site for reconstructive nasal repairs because of its similar color and texture to the nose. A forehead flap is appropriate for nasal defects that are deep, larger than 1.5 cm, or require cartilage support and lining replacement. Forehead flap procedures may be performed in two or three stages, depending upon the severity of the defect, and are typically performed under general anesthesia.