Decision making in nasal reconstruction.

Nasal reconstruction is a challenging and rewarding discipline. The nasal subunit principle dramatically improved the surgeon's ability to reconstruct nasal defects by helping disguise incisions within subunit borders and by providing a tool to help in reconstructive decision making. Selection of the proper reconstruction must include the patient's medicosocial situation and the patient's cosmetic concerns. In addition, functional considerations, such as nasal obstruction, that may result from the chosen reconstruction must be carefully considered. For any defect, the most appropriate reconstructive technique is the simplest and most cost-effective method that meets each individual patient's medical, functional, social, and cosmetic goals.