Z. Dvořák1,2, M. Kubát1, A. Berkeš1, J. Menoušek 1, R. Pink3, T. Kubek3, I. Polovko1
1 Department of Plastic and Aesthetic Surgery, St. Anne’s University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic2 Department of Oral and Maxillofacial Surgery, University Hospital Olomouc and Faculty of Medicine, Palacký University Olomouc, Czech Republic3 Department of Surgical Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
Summary
Background: Earlier nasal reconstruction techniques focused primarily on restoring the cutaneous envelope and the central portion of the nasal framework. Unfortunately, these approaches often produced results that were unstable over time, leading to secondary deformities and scarring of the reconstructed nose. Modern nasal reconstruction techniques rely on comprehensive restoration of all anatomical layers, with particular emphasis on rebuilding the structural support layer. This supportive framework is now routinely reconstructed not only in the central part as in the past, but also along the lateral nasal walls, using cartilage or (for reinforcement of the dorsum of the nose) thin bony grafts. Evaluation of the topic: The nasal framework implantation is typically performed in the first stage of nose reconstruction; in patients with thick soft-tissue cover, however, it may be postponed to the period after soft-tissue thinning in a second stage. It is essential to restore both the central supporting framework and the lateral nasal walls, including adequate alar support. Graft materials commonly used for this purpose include non-vascularized cartilage harvested from the auricular conchal bowl, the rib, or the nasal septum, and bone grafts from the skull (outer parietal cortex) or rib. Conclusion: The results of modern reconstruction dramatically improved after emphasis was put on the reconstruction of all layers of the nose. In particular, complete reconstruction of the nasal framework – both the rigid and cartilaginous components – is crucial for long-term stability, prevention of postoperative collapse of the reconstructed nose, and maintaining the patency and function of the upper airway.
Key words
reconstructive surgery – acquired nasal deformities – nasal surgery – nasal framework – supporting layer
Dvořák Z, Kubát M, Berkeš A et al. Principles of nasal framework reconstruction for complex nasal defects: review. Acta Chir Plast 2026; 68 (1–2): 34–41.