Reconstructive rhinoplasty for the lower two-thirds of the nose.

A general format has been developed and used for reconstruction of the lower two-thirds of the nose in patients retaining some septum who have a low forehead. The lining above the alae comes from strategic local flaps, while the alar lining and most of the columella are produced by a pair of nasolabial flaps. Support is provided by the residual septum (sometimes advance), and by a later costal chondroperichondrial hinge graft. The cover comes from a "headless" gull-shaped, forehead flap.