Reconstruction of the nasal tip.

Defects of the nasal tip present complex problems in terms of reconstruction, since they involve an important region both from functional and anatomical points of view. The authors present their experience in reconstructive surgery of the nasal tip, evaluating the results related to the use of flaps and free grafts. Among their cases, 132 patients were selected, with a prevalence of female patients, with a median age of 60. The deformities observed were postsurgical, following the exeresis of benign and malignant neoformations. The techniques utilized involved the use of median frontal, nasomental and nasolabial flaps. Of all of the patients treated, good aesthetic results were obtained in 79% of the cases, characterized by a good projection of the tip and by minor scar retraction, with full satisfaction on the part of the surgeon and the patient. On the other hand, some patients were defined as nonsatisfactory, with the deformity caused by scar retraction of the tip and abnormalities in color and thickness of the skin grafted. With a few exceptions, the patients had a good postoperative recovery without events worthy of note. On the basis of the results obtained, we can recommend advancement flap for lateral nasal defects, transposition of nasolabial flap for the reconstruction of the nasal alar. Naso-labial flaps with a subcutaneous pedicle are effective for correcting injures or defects involving the lateral surface of the nose.