Art and Artistry of Three-Dimensional Nasal Reconstruction

The nose is not only an important part of human appearance but also performs important functions, including olfaction, humidification, and breathing. The history of nasal reconstruction dates back to 600 BC (Sushruta, India), and the Indian method using a forehead flap remains to this day the criterion standard for large defects. The art of nasal reconstruction has travelled across many countries and continents and benefited from their surgical contributions. An understanding of nasal subunits, arterial anatomy, and knowledge of skin zones is critical in planning any reconstruction. A stepwise logical planning process helps in deciding the right choices for reconstruction. It is vital to recreate all three layers of the nose, namely skin, skeletal support, and nasal lining. Local nose and facial flaps form the backbone of nasal reconstruction. Skeletal support is vital to providing shape and stability to any nasal construct. Nasal lining restoration is important for maintaining the patency of the airways. Patience, persistence, and the use of reliable techniques can make nasal reconstruction a predictable and rewarding experience for every plastic surgeon