Early local flap reconstruction in nasal defect due to severe infection after rhinoplasty

Objective: To explore the feasibility, option of surgical method and surgery opportunity of local flap reconstruction in nasal defects due to severe infection after rhinoplasty.

Methods: The clinical datum of eleven patients, who had 15 cases of local flap reconstruction due to severe infection after rhinoplasty, were analyzed retrospectively. The lesions included defects of nasal dorsum, nasal tip and anterior-nare-vestibular fistula. Areas of defects ranged from 1.5 cm x 1.2 cm to 2.0 cm x 2.5 cm and fistula diameters fell between 0.6 cm and 0.9 cm. Based on the principal of nasal aesthetic sub-unit, nasal defects were restored with local flaps, such as nasal dorsum flaps, rhomboid flaps and nasal columella-tip flaps. The early changes and the maintenances of nasal contour after reconstruction were observed.

Results: All 15 reconstructions were carried out 2 weeks after control of infection, and stage-I recovery was achieved in all the cases. In the follow-up periods from 4 to 27 months, all the flaps survived. only 2 cases had distortion of nasal tips, however, they were recovered with subcutaneous injection restoration; the other cases received satisfactory nasal contour where the flaps matched well with the neighbor skin in color, texture and extent of actinic dermatitis.

Conclusions: Based on the principal of nasal aesthetic sub-unit, the individualized early local flap reconstruction would have good effect on nasal function and aesthetics, which will restore self-confidence of the patients as soon as possible.