[Reconstruction of nose defects by combined multiple flap-plasties and stabilization with cartilage transplants]

In the reconstruction of nasal defects, the method of choice involves flaps from the immediate surroundings (nose, cheek, forehead), because of their superior skin colour and texture match. In defects involving all layers of the nose, the inner lining and the nasal skeleton must also be reconstructed. These procedures are often performed in several steps, with incision and elevation of flaps, implantation of cartilage and skin-grafting of the donor site (prefabricating). By using one flap to replace the missing skin and a second flap for inner lining, a stabilizing cartilage graft can be inserted primarily. Using this "sandwich-technique", subtotal nose reconstructions can be performed in a single stage as well. Between 1986 and 1996, 23 patients underwent nasal reconstructions using local flaps. Our reconstructive concept is demonstrated by means of several clinical cases.