Simple approach yields best results

New Orleans - Facial reconstruction does not have to be as complicated a procedure as it might sound, according to Ken K. Lee, M.D., who presented a seminar on facial reconstruction at the 63^rd Annual Meeting of the American Academy of Dermatology (AAD) here.

Linear closures for the nose Dr. Lee places emphasis on several facial reconstruction procedures, beginning with linear closures for the nose.

He adds that surgeons should be wary of alar retraction and internal valve compromise if the closure is too tight.

"The surgeon should close the superior and inferior aspects of the defect in similar fashion to linear closure," Dr. Lee says. "A superior dog ear, shaped in a fusiform elliptical configuration, should be used as the graft. One may need to thin the graft more than usual and set it in slightly."

"In this procedure, one should try to keep incisions on the cutaneous lip in a vertical/radial direction, and shouldn't be afraid to cross the vermilion border," he says. "The surgeon should remove as little or as much muscle as needed to settle down the dog ear and extend the incision through the dry vermilion so that an abrupt interruption is not seen. The vermilion border should then be carefully re-approximated."