Abstract
The nose is a frequent site for skin cancer, accounting for approximately 26% of basal
cell carcinomas and approximately 13% of spinal cell carcinomas of the facial district.
Also melanomas, mostly as lentigo maligna melanomas, are frequently located at the
nasal pyramid. Although defects can be of varying size and depth, some even involving
the whole trilaminar structure of the nose, most remain superficial and seldom reach
and infiltrate the underlying framework. In contrast, they can be wide, thus requesting
large flaps to resurface the defect. Although a technically well-planned and well-performed
surgery can lead to excellent aesthetic results, scars from both donor and recipient
sites can be noticeable. Since skin cancers generally affect older people, we often
deal with aged noses. Such noses typically present some common features such as plunging
tip, increased length, and a prominent hump due to several reasons, already well described
in the literature. In this scenario, by reducing and addressing the framework, we
can obtain a variable quota of downsizing of the original defect, thus requiring less
skin for coverage, and thus reducing the size of needed flaps and consequent scars.
This is greatly facilitated by the open rhinoplasty approach. Most of the maneuvers
aimed at reducing the framework are indeed the same.
Keywords
nasal framework - nasal reconstruction - aging nose - open rhinoplasty
