A report from China describes how a Chinese surgeon constructed a nose from a patient’s rib cartilage and implanted it under the skin of the patient’s forehead in preparation for a transplant to his face. Surgeon Guo Zhihui of Fujian Medical University Union Hospital, in the province of Fujian, spent nine months cultivating the graft for a 22-year-old man whose nose had been badly damaged. The story was reported by Louise Watt in Beijing and Didi Tang for the Associated Press.
The patient lost part of his nose in an accident in August 2012, and could not afford reconstructive surgery, Guo reported. Later an infection ate away much of his nose cartilage. Guo said his team examined what remained of the nose and concluded there would be little chance of viably grafting cartilage there. So Guo decided to construct the nose on the patient’s forehead, spending nine months cultivating the graft.
The team first expanded skin on the man’s forehead for more than three months before using rib cartilage to build the nose bridge. Striking images of the implant—with the nostril section facing diagonally upward on the left side of the man’s forehead—circulated widely in Chinese media. Guo plans to cut the nose from the forehead, while leaving a section of skin still connected, and then rotate and graft it into position in a later operation.
When the new nose is rotated into position and grafted, it will at first have its own blood supply from links to the forehead, before developing new blood vessels. Later surgery will smooth out all of the skin. Lastly, Guo’s team built the nostrils. “We sculpted the nose three-dimensionally, like carpenters, ” he said.
