Reconstruction of a large through-and-through defect of the nasal tip using a modified auricular composite graft.

Abstract

The nose is the most important part in the aesthetic appearance of the face because of its central position. It is difficult to reconstruct a large through-and through defect of the nasal tip among nasal defect deformities because of its unique individual characteristics. In this article, we describe the successful use of a modified auricular composite graft (larger than traditional size) for the reconstruction of large transmural defects of the nasal tip. We retrospectively examined 4 patients diagnosed with a defect of the nasal tip between 2009 and 2011; in our patients, the size of the defect was between 2 × 1 cm and 2.5 × 1 cm. All of them received the same surgical method. The patients were followed up from 3 to 12 months. After the operation, the patients had hyperbaric oxygen therapy for 7 days to improve graft oxygenation. All patients attained relatively full-bodied and smooth nasal contours as well as inconspicuous scars and found their reconstructed nasal tip and alae to be aesthetically satisfactory. Two patients experienced partial epidermal necrosis of the transplanted auricular composite grafts, which was recovered by saline-moistened gauze dressing. All the auricular composite tissue flaps had color change, and the contours of donor ears had little change.