The shape of the nose contributes a great deal to the appearance of the face. A deformed nose gives the face an unpleasant appearance. The nose may be deformed by birth or may be injured in an accident. If the shape of the nose is not symmetrical, this too changes the appearance giving an unpleasant look. The deformity can be corrected by reconstructive surgery.
The nose is a complex structure that is made up of a bony skeletal framework, combined with a unique type of specialized bone-like elastic tissue called cartilage and soft tissues constituting of muscles and skin. To reconstruct the shape of the nose, a graft has to be taken from other parts of the body. But a major concern is that the color of the graft taken should match the color of the nose otherwise it will result in an ugly scarred appearance. To avoid this, a graft taken from the forehead is the best choice. The forehead is very close to the nose and also its color matches that of the nose perfectly.
Orthognathic surgery is basically surgery performed on the bones of the jaws to change their position and size. It involves repositioning all or part of the upper or lower jaw or chin in alignment. Sometimes, bone may be added, taken away or reshaped. When the jaws are moved forwards or backwards, up or down, or rotated, the soft tissue in the chin, cheeks, lips and tip of the nose move accordingly. Therefore, once the jaws are correctly positioned, the architecture of the facial skeleton is changed and a harmony between the facial features is achieved. This results in a facial profile that is pleasing or in fact even more beautiful to look at.
Nasal defect before treatment
Nasal defect Side View before treatment
Placement of forehead flap
Placement of forehead flap Nose Reconstruction
Post operative view after one month
Post operative side view after one month
This reconstruction is a surgical procedure in which a graft consisting of a section of the skin along with blood vessels is lifted from the forehead region with the base of the graft still attached to the forehead in between the eyebrows. The wound on the forehead is sutured. The graft is then brought downwards and attached to the nose tip.
After blood supply is established in the nose, the graft tissue is cut off from the forehead. With this reconstruction, there is no color mismatch and it gives the nose a more normal appearance. Along with this if required, cartilage grafts from the ribs can be taken to reconstruct the side or central prominence of the nose. The type of reconstructive surgery required will depend on the extent of deformity of the nose.
A boy's nose severely injured in an accident
Forehead flap used for nose reconstruction
Few days after nose reconstruction surgery
The photographs of a 7-year-old boy show how the nose injured in an accident was reconstructed using a graft from the forehead. The sharpness of the nose and nose tip is accurately reconstructed to give a more natural form and appearance. The photographs of a 20-year-old girl show how the shape of the nostrils was deformed since birth. The side of the nose is rebuilt giving a more normal structure and appearance.
A social worker and human rights activist was referred to Balaji Dental and Craniofacial Hospital for specialized reconstructive surgery of the nose. His work involved him to interact with many people from different walks of life. In one such encounter, during a civil unrest, a miscreant bit his nose. After initial first aid treatment, he was referred here for expert care.