How Would You Reconstruct It?

The presentation discusses various surgical techniques used for reconstructing facial defects, particularly in the nasal and eyelid areas. Emphasis is placed on different flap types including the AV to Y flap for minimal undermining, Burrows grafts, and full-thickness skin grafts, with recommendations for specific techniques based on defect characteristics. The conversation between surgeons includes creative approaches like using cartilage grafts, bilobe flaps, and nasal tip rotation flaps, explaining the intricacies of each method and the importance of achieving aesthetic outcomes. Key decisions such as whether to tack flaps into place and approaches for addressing deeper defects are explored, highlighting the balance between functional and cosmetic considerations. Case studies illustrate the effectiveness of techniques and the importance of careful planning in surgery, as shown in a young woman with a tight nose and a defect that required various strategic flap applications. The discussion also touches on considerations for patients’ preferences and tissue viability, all while aiming to maintain facial symmetry and natural appearance over time.