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Difficult Nasal Reconstruction with Modified Composite Grafts Revisited
Stephen Lopez MD
Lawrence Cervino MD
Summa Health Akron Ohio
2017-02-15
Presenter: Stephen Lopez MD
Affidavit:
This material is new updated material from prior published work by Dr. Cervino with new more complex clinical examples. The resident has performed majority of the data collection and presentation.
Director Name: Douglas Wagner
Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
Background: Comsetically sensitive areas of the nose such as the columella, colummellar-lobule junction, alar rim, soft triangle and vestibular skin are challenging to reconstruct. We have previously described reconstruction of these challenging areas using modified composite grafts (MCG). The modified composite grafts use dermal extensions to allow greater surface contact between the graft and the recipient bed. With postoperative cooling in grafts larger than 1.5cm we have demonstrated increased graft size survival in 50 patients. Here we show more difficult reconstructions using MCG with reconstructions of the columella, colummellar-lobule junction including nasal vestibule. We demonstrate that these grafts can be used to reconstruct these difficult cosmetically sensitive areas in a single stage reconstruction which prevent the need for local flaps avoiding donor site scars with excellent results.
Methods: Review of 8 consecutive patients with difficult nasal reconstructions involving the columella, colummelar-lobule junction and/or nasal vestibule with the use of modified composite grafts alone. Greater than one year follow up.
Results: There were no graft failures or reconstruction revisions needed. No complications were reported in this case series. All patients were happy with their aesthetic outcomes.
Conclusion: Modified composite grafts can be used to reconstruct difficult cosmetically sensitive areas in a single stage reconstruction without the need for local donor site scars while achieving excellent aesthetic results.
