Abstract
Although most nasal reconstructions are performed using local tissues, there are 2 groups of patients who may benefit from nasal reconstruction using microsurgical techniques. The first group is patients with a subtotal loss of the distal part of the nose that may be reconstructed with a free flap from the ascending helix of the ear, which has a remarkably similar appearance to the distal part of the nose. The second group is patients who have sustained a total loss of the nose, including all layers and often adjacent tissues, who may be reconstructed in a staged fashion with a prelaminated flap from the forearm. This flap has previously been lined and laminated with structural support and subsequently transferred to the face. These flaps need revisions and generally a forehead flap for final esthetic coverage once they have stabilized.
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