Soft tissue reconstruction of the nose

Soft tissue repair of skin defects of the nose-being in the middle of the face-is very demanding with regard to its functional and aesthetic outcome to allow successful rehabilitation of the patient concerned. In the majority of these cases, soft tissue reconstruction using local and regional flaps is indicated after individual therapy planning considering location and size of the defect, the patient's age, and his or her wishes. Flaps from nasal skin, glabella, forehead, as well as nasolabial fold provide good possibilities to cover the defect externally and ensure matching color and texture. Full-thickness skin grafts and healing by secondary intent are second-choice therapies. In the case of partial amputation of the nose, a nasolabial rotation flap can be used for inner lining, if necessary supported by septal cartilage or a composite graft building a stable nasal scaffold from the inside for the outside. The possibilities of facial plastic surgery, the exact knowledge of vascular supply, and flaps adjusted to individual requirements allow achievement of an outcome that is aesthetically and functionally satisfying for the patient.