Resumo

Objectives: understanding the special anatomy of the nasal pyramid understanding the criteria for choosing which flap to close a local defect in the nose area tipps and tricks to consider in reconstructive surgery of the nose Introduction: The complex three dimensional anatomy of the nasal pyramid is always a challenge to reconstruct, specially in skin cancer surgery with local flaps after excision. Materials / method: In a retrospective study of 350 patients who have been operated between 2013 and 2022 we analyze the aesthetic result and function after reconstructive surgery of the nose , concerning the different localization of the cancer and le chosen local flaps of reconstruction. Complications and special difficulties in this type of surgery are discussed. Results: Our preferred and mostly used local flaps are the glabellar flap for defects of the upper third of the nasal pyramid , Rieger/ Marchac flap for the lower third of the nasal pyramid / nasal tip, the bilobed flap for defects of the lateral portion of the nasal pyramid and nasolabial fold advancement flaps to close defects of the alar area . Conclusion: Respecting the aesthetic units and taking consideration of the complex anatomy of the external nose we give some guidelines to get optimal form and function in reconstructive surgery of the nose.