A Novel Approach for Total Nasal Reconstruction.

A 61-year-old woman who lost her nose, upper lip, and most of her midface bony structures because of cancer 20 years previously underwent advanced surgical reconstruction. This patient previously underwent multiple reconstructive surgeries that failed to satisfactorily restore her nose. Therefore, a multistage reconstruction was performed to recreate a complete nose and increase her upper lip length. Because of a lack of sufficient facial bone and nasal supporting structures, the reconstruction was extremely challenging. Virtual surgical planning technology was used to create a customized titanium nasal plate. The patient's nose was successfully reconstructed using the nasal plate, costal cartilage, and a paramedian forehead flap. The patient is highly satisfied with the cosmetic and functional results and has had marked psychosocial improvement since the reconstruction.