Because the nose is a very prominent aesthetic feature of the face, wounds located here are particularly challenging from a reconstructive perspective. Poor tissue availability and the potential for introducing anatomic distortion certainly increase surgical complexity. There are common misconceptions regarding nasal reconstruction that may impede the physician’s ability to deliver optimal care. Understanding that these commonly held assumptions about nasal wound repair are incorrect should increase the surgeon’s nasal reconstructive abilities. The basic principles of reconstructive surgery are not uniquely applicable to the repair of nasal defects; the consequences of surgical misjudgments on the nose are simply magnified in comparison to surgical problems in other less visually prominent locations. To handle nasal surgical wounds with expertise, the dermatologic surgeon should first realize that there are common misconceptions that often hinder effective clinical decision making. By realizing that these incorrect assumptions can reduce success in nasal reconstruction, the surgeon should be able to more appropriately select nasal repair procedures that will accomplish the common goals of any facial reconstructive surgery: to preserve function, to restore appearance, and to minimize surgical risk.

BECAUSE OF ITS visual prominence in the central face, the nose offers ample evidence of the dermatologic surgeon’s reconstructive successes and failures.