title: Reconstruction of nasal defects using modified composite grafts.
abstract: Nasal defects in certain areas such as the columellar-lobular junction, the alar rim and the soft triangle are cosmetically challenging to reconstruct. This paper describes a technique that enables the use of composite grafts for these specific nasal defects. Termed modified composite grafts (MCG), they involve creation of a dermal pedicle on the graft that enlarges the surface area of contact between the graft and the recipient bed. In addition, we used postoperative surface cooling for grafts larger than 1.5cm. Both these modifications allow reconstruction of defects larger than 1.5cm, improve graft survival and yield a better cosmetic outcome. Using representative cases from our series of 50 patients, we demonstrate that MCGs provide a simple, single-staged alternative to otherwise complex reconstruction of specific areas of the nose. They offset the need for local flaps, avoid donor-site scars and yield excellent long-term results.
authors.affiliation: Crystal Plastic Surgeons, Crystal Clinic and, Division of Plastic Surgery, Akron General Medical Center, Summa Health System and, North Eastern Ohio Universities College of Medicine, Akron, OH, USA.
authors.forename: R Y
authors.initials: RY
authors.lastname: Chandawarkar
authors.forename: A L
authors.initials: AL
authors.lastname: Cervino
authors.forename: M D
authors.initials: MD
authors.lastname: Wells
mesh_terms: D002280:Basal Cell Carcinoma / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D009667:Nose Deformities, Acquired / Q000601:surgery*; D009669:Nose Neoplasms / Q000601:surgery; D012225:Rhinoplasty / Q000379:methods*; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps; D016896:Treatment Outcome