Reconstructive rhinoplasty (replacement surgery)

The statement made by von Mikulicz in 1884 is still valid today: “Probably no other defect on the face is as small or as hard to reconstruct as that of the cutaneous septum of the nose.” Total defect of the columella can occur as a result of syphilis, trauma, and tumor resection. Reconstruction is done by using parts of the upper lip, the neighboring cheeks or the forehead, or by means of small tubed pedicle flaps from the upper arm or by means of free grafts from the ear.