Is this the same as cosmetic rhinoplasty?
No. Nasal reconstruction primarily repairs tissue loss or damage.
Cosmetic rhinoplasty mainly reshapes the nose. Some techniques overlap, and reconstruction may also change appearance.
Reconstructive Surgery · Nose
Nasal Reconstruction
Nasal reconstruction repairs missing or damaged nasal tissue after cancer removal, injury, or other causes, with attention to breathing and appearance.
Will I need more than one operation?
Some repairs take one operation; others require planned stages.
Larger repairs may need a flap that stays attached to its blood supply until a later operation.
Can it help breathing?
Restoring support or lining may help when tissue damage narrows the airway.
A surgeon must assess the cause of blockage. Reconstruction cannot guarantee improved breathing.
01 · Overview
Rebuilding the nose’s structure and covering
Nasal reconstruction may follow skin cancer removal, an accident, or another condition that damages the nose. A small skin defect and a deeper wound involving the nostril or framework need different approaches. [1]
Repair may use nearby skin, a skin graft, or tissue moved from another area while preserving its blood supply. Cartilage may also be needed to support the nostril or restore shape. Deeper defects may require replacement of the inner lining as well. [2]
The aim is a stable, healed repair that supports nasal function and fits your facial features as well as possible. Reconstructed tissue can differ in color, thickness, or contour, and scars are expected. Your surgeon will explain what is realistic for your particular defect. [1]
- Main purpose
- Repair missing or damaged nasal tissue
- Tissues involved
- Skin, cartilage support, and sometimes inner lining
- Treatment course
- One operation or a staged repair
- Anesthesia
- Local anesthesia, sedation, or general anesthesia, depending on the repair
How is this different from septoplasty?
Septoplasty treats a bent internal nasal septum. Nasal reconstruction repairs missing or damaged tissue and may involve several nasal layers. Septal work is included only when it serves the reconstruction or addresses a separate assessed problem.
Who coordinates repair after skin cancer removal?
The clinician removing the cancer and the reconstructive surgeon coordinate timing. The final repair depends on the wound’s size and depth and whether further cancer treatment is needed.
02 · Concerns & Goals
What brings people to a consultation
The nose has an outer skin covering, a supporting framework, and an inner lining. Your plan depends on which layers need repair and what matters most to you.
An open area after cancer removal
You may need coverage after Mohs surgery or another cancer operation. The final wound may be larger or deeper than the original visible spot.
Damage after an injury
An injury can affect skin, cartilage, bone, or lining. Repair planning considers both healing and the support needed to keep the nostrils open.
Nostril narrowing or collapse
Lost support or scar tightening can change airflow. Your surgeon will check whether the problem comes from the reconstructed area or another part of the airway.
Changes in shape or symmetry
A missing edge, uneven contour, or prominent scar may affect how you feel about your nose. Improvement may be possible, but exact symmetry is not a realistic promise.
03 · Options
How the approaches differ
These methods may be used alone or together. A surgeon recommends an approach based on the defect, blood supply, available tissue, and your health.
Direct closure
Bring the wound edges together with stitches.
How it worksThe surgeon closes the defect when there is enough nearby skin without pulling the nose out of shape.
May suitSelected small defects with suitable skin flexibility.
Main tradeoffEven a small closure can pull on a nostril or alter contour if there is too much tension.
Skin graft
Cover a defect with skin taken from another area.
How it worksA thin piece of skin is transferred to a wound bed that can provide it with a new blood supply.
May suitSelected surface defects with adequate underlying tissue.
Main tradeoffColor or thickness may not match, the graft may shrink, and the donor area also needs to heal.
Local or regional flap
Move living tissue into the defect while maintaining a blood supply.
How it worksSkin may come from the nose, cheek, or forehead. Some flaps remain temporarily connected to the donor area before a later separation procedure.
May suitDefects needing more substantial coverage or tissue with its own blood supply.
Main tradeoffAdditional scars, temporary bulk, and more than one operation may be part of treatment.
Layered reconstruction
Rebuild lining, support, and outer coverage when several layers are missing.
How it worksLining repair and cartilage grafts, often from the ear, septum, or rib, are combined with suitable outer coverage.
May suitDeep or full-thickness defects and repairs needing nostril support.
Main tradeoffThis is more complex and may involve donor-site discomfort, staged surgery, and later contour adjustments.
These are repair approaches, not interchangeable packages. Skin coverage alone may not be enough when support or lining is missing. [1] [2].
Why might forehead skin be used?
A forehead flap can provide living tissue for a larger nasal defect. It usually remains attached by a bridge of tissue during early healing, with a later operation to divide the attachment. Ask to see a diagram of each planned stage.
Is a second operation always a complication?
No. Flap separation or thinning may be planned from the start. An unplanned operation treats a problem or an outcome that needs further correction. Your plan should distinguish these clearly.
04 · Results
What may improve and what may remain
A healed, protected repair
Closing the defect is an important goal, but healing varies.
- A graft or flap needs an adequate blood supply to survive.
- Nicotine exposure, prior radiation, infection, and some health conditions can complicate healing.
Support and airflow
Rebuilding support may help preserve or improve the nasal opening.
- Swelling can temporarily make breathing feel more restricted.
- Scar tightening or persistent structural problems may require further assessment.
Contour and scars
Appearance continues to change as swelling settles and scars soften.
- Reconstructed skin may remain different in texture, color, or thickness.
- Later refinement may be discussed, but it cannot guarantee a perfect match or symmetry.
Reconstruction can restore form and function after tissue loss, but the extent of damage and the healing process limit what can be achieved. [1]
05 · Recovery
Planning your recovery
Recovery at a glance
- Stay after surgery
- Determined by Your Surgeon
- Initial recovery at home
- Varies by Individual
- Return to desk work
- Varies by Procedure and Work Activity
- Light daily activities
- Based on Individual Recovery
- Strenuous exercise
- Based on Surgeon Clearance
Returning to work does not mean fully healed. Follow your surgeon’s instructions; strenuous activity requires clearance.
Recovery depends on the repair and whether treatment is staged. Your surgical team’s written instructions take priority, especially for dressings, flap protection, and donor-site care.
Step 1 · Day of surgery
Treatment day
You may leave with dressings, a graft bolster, or a visible flap attachment. The team explains what must stay in place and whether you need a ride and help at home.
Step 2 · First days to weeks
Early wound checks
Visits check blood supply and wound healing and allow removal of selected stitches or dressings. Swelling, bruising, and tenderness are common. Ask your surgical team whether compresses are appropriate and exactly how to use them.
Step 3 · Over the following weeks or longer
Further stages, if planned
A flap may need separation, shaping, or another planned procedure once it has sufficient blood supply. Timing is individualized, and each operation brings another recovery period.
Step 4 · Over several months
Scar and contour settling
Swelling and scar firmness can improve gradually. The team assesses airflow, scar tightening, and whether later refinement is appropriate. Returning to work does not mean healing is complete.
Planning everyday activities
ActivityGeneral planning contextWhat affects the plan
Work and social plansPlanning context: Time away varies with the repair and job demands.What affects it: Visible dressings, a flap attachment, fatigue, and staged appointments can affect your schedule.
Exercise and liftingPlanning context: Resume only within your team’s restrictions. [2]What affects it: Straining or impact can cause bleeding or stress the repair.
Glasses and face coveringsPlanning context: Ask how to avoid pressure on healing tissue.What affects it: Frames, straps, or masks may rub or compress a graft or flap.
DrivingPlanning context: Wait until your team clears you and you can drive safely.What affects it: Sedation, impairing pain medicine, and dressings that limit vision can make driving unsafe.
Ask for restrictions specific to your reconstruction and donor site; a small graft and a staged forehead flap have different recovery needs.
Before your procedure
- Share your cancer treatment, injury, radiation, and previous nasal surgery history.
- Review all medicines and supplements; do not stop prescribed treatment without instructions.
- Discuss nicotine use and the team’s requirements before and after surgery.
- Ask which repair options may depend on the final size of the wound.
- Plan transportation, home support, and time for each expected operation.
- Get written guidance on fasting, wound care, follow-up, and after-hours contact.
How do I care for a graft or flap?
Care depends on the tissue and dressings used. Ask which areas may get wet, what to apply, and what must remain untouched. Do not lift a bolster or change a dressing unless your team has instructed you to do so.
Will the donor site need care too?
Yes. Skin or cartilage taken from another area leaves a separate healing site. Ask about discomfort, activity limits, scar care, and warning signs for that location.
06 · Safety
Risks and what your clinician assesses
Swelling, bruising, tenderness, temporary numbness, and visible scars are common. Nasal stuffiness and donor-site soreness may also occur. Your team should explain what is expected for your repair and what needs prompt assessment.
Bleeding or a blood collection
Bleeding can occur under a repair or at a donor site and may need treatment.
Infection or delayed healing
A wound can become infected, open, or heal slowly, sometimes requiring additional care or surgery.
Graft or flap loss
Part or all of transferred tissue may not survive if its blood supply is inadequate.
Scarring or contour differences
Raised scars, color mismatch, unevenness, or unwanted bulk may remain. Further correction may be considered.
Breathing or support problems
Scar tightening, nostril narrowing, or changes in cartilage support may cause persistent or new airflow problems.
Anesthesia and donor-site complications
Anesthesia can cause adverse reactions. Donor areas can develop pain, numbness, scars, or contour changes; risks depend on where tissue is taken.
Discuss these risks and your individual health history with your surgeon. [2]
What your clinician assesses
- Defect size, depth, location, and involvement of the nostril or lining
- Nasal airflow, existing support, and prior operations or radiation
- Blood supply, nicotine exposure, diabetes, and other healing factors
- Cancer treatment needs, anesthesia safety, and ability to manage staged care
07 · Costs
What makes up the Total Procedure & Care Cost
Compare written estimates for the same planned scope, including the expected number of stages, donor-site work, anesthesia, and follow-up. Coverage and out-of-pocket costs depend on your insurance plan and the proposed repair.
Surgeon
Surgical care
Surgeon services for reconstruction and any planned stages.
Ask your surgeonAsk whether cancer removal, cartilage harvest, flap separation, and later refinements are billed separately.
Facility
Anesthesia and facility
Anesthesia services and the office, surgery center, or hospital setting.
Ask your surgeonConfirm separate professional and facility charges for each planned operation.
Supplies
Supplies and follow-up
Dressings, prescribed medicines, wound checks, and donor-site follow-up.
Ask your surgeonAsk what is included and how additional wound care or an unplanned procedure would be charged.
TRC
Patient Services
Any separately listed scheduling, administrative, or care-coordination services.
Ask TRCAsk whether these services carry a fee and whether insurance covers that fee.
Your written estimate should explain the services included, any separate charges, and payment terms.
08 · Questions
Common questions
Can reconstruction happen on the same day as Mohs surgery?
Sometimes. Timing depends on cancer clearance, the final defect, and coordination between teams. Other repairs are scheduled later with a wound-care plan in place.
Will my nose look exactly as it did before?
That cannot be promised. Reconstruction aims to restore coverage, support, and a balanced appearance, but tissue loss and scars can leave lasting differences.
Will I have a scar somewhere other than my nose?
You may. Skin grafts, regional flaps, and cartilage grafts can create donor-site scars. Ask where tissue would come from and what changes to expect there.
Does reconstruction replace skin cancer follow-up?
No. Continue the skin examinations and cancer follow-up recommended by your treating clinician, even after the reconstruction has healed.
0 consultation questions in your plan
View in My TRC workspaceMy Aesthetic Plan
Prepare for your consultation
Bring these to help your consultation:
- Understand the proposed repair, alternatives, donor sites, and planned stages.
- Arrange individualized wound-care instructions, support at home, and follow-up.
- Confirm the written estimate, coverage requirements, and after-hours contact.
View My Aesthetic Plan
Choices stay in this visit until saving to your account completes. Nothing is sent to a clinician.
Sources
- [1]American Society of Plastic Surgeons — Skin Cancer RemovalReconstruction after skin cancer removal, use of grafts and flaps, appearance limitations, and reconstructive alternatives.
- [2]MedlinePlus — Skin flaps and grafts: self-careGraft and flap blood supply, donor-site healing, individualized wound protection and activity restrictions, healing complications, and warning signs requiring contact with the surgical team.
Photographs are illustrative scenes, not patients, staff, facilities or outcomes. This information does not replace a personal assessment by your treating clinician.