Reconstructing the Nasal Tip After a Human Bite: A Challenge for the Reconstructive Surgeon

  • Panagiotis StathopoulosEmail author
  • Phillip Ameerally
Clinical Paper



Human facial bites are uncommon and usually cause a wound that presents major challenges for the reconstructive surgeon.


The purpose of this study is to present the advantages and disadvantages of using a superiorly based interpolated nasolabial flap for reconstruction of a nasal tip defect.


We present a case of serious injury of the nasal tip as a result of a human bite. Early maxillofacial surgical intervention resulted in restoration of the facial anatomy and function of the structures involved.

Results and Conclusion

We present a serious mutilating injury of the tip of the nose in a young patient as a result of a human bite. These injuries can be rather destructive and cause a facial defect which may have a significant adverse psychological impact on the patient. Because of the proximity and the skin colour match of the melolabial fold to the nose, nasolabial flaps are a very attractive and reliable reconstructive choice for nasal tip defects. The relative advantages over other reconstructive options and the limitations of an interpolated superiorly based nasolabial flap are discussed. The elaborated use of a nasolabial peninsular pedicled skin flap may deliver a very satisfactory outcome from a functional and cosmetic point of view.


Human bite Nasolabial flap Nasal reconstruction 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    UK Department of Health (1998) Guidance for Clinical Health Care Workers: protection against infection with blood-borne viruses: recommendations of the Expert Advisory Group on AIDS and the Advisory Group on Hepatitis. UK Health Department, LondonGoogle Scholar
  2. 2.
    El-Marakby HH (2005) The versatile naso-labial flaps in facial reconstruction. J Egypt Natl Cancer Inst 17(4):245–250Google Scholar
  3. 3.
    Rueff F, Bedacht R, Schury G (1967) Bite injury. Special situation as to clinical aspects, therapy and course of healing. Med Welt 12:663–668Google Scholar
  4. 4.
    Norton C (2008) Animal and human bites. J Emerg Nurse 16:26–29CrossRefGoogle Scholar
  5. 5.
    Brook I (2009) Management of human and animal bite wound infection: an overview. Curr Infect Dis Rep 11:389–395CrossRefGoogle Scholar
  6. 6.
    Baker S (2007) Melolabial flaps in local flaps in facial reconstruction, 2nd edn. Mosby, Philadelphia, pp 243–264Google Scholar
  7. 7.
    Stefanopoulos PK, Tarantzopoulou AD (2009) Management of facial bite wounds. Dent Clin N Am 53:691–705CrossRefGoogle Scholar
  8. 8.
    Stefanopoulos PK, Tarantzopoulou AD (2005) Facial bite wounds: management update. Int J Oral Maxillofac Surg 34:464–472CrossRefGoogle Scholar
  9. 9.
    Kaluzinski E, Crasson F, Alix T, Labbe D (2004) Nasolabial flap reconstruction of the collumella. Rev Stomatol Chir Maxillofac 105:171CrossRefGoogle Scholar
  10. 10.
    Cameron RR (1998) Nasolabial and check flaps. In: Straunch B, Vanconez LO, Hall-Findlay EJ (eds) Grabb’s encyclopedia of flaps, vol 1, 2nd edn. Lippincott-Raven, Philadelphia, pp 56–61Google Scholar
  11. 11.
    Da Silva GA (1964) A new method of reconstructing the columella with a nasolabial flap. Plast Reconstr Surg 34:63CrossRefGoogle Scholar
  12. 12.
    Kaplan I (1972) Reconstruction of the collumella. Br J Plast Surg 25:37CrossRefGoogle Scholar
  13. 13.
    Ohtsuka H (1998) Nasolabial flaps to the cheek. In: Straunch B, Vanconez LO, Hall-Findlay EJ (eds) Grabb’s encyclopedia of flaps, 2nd edn. Lippincott-Raven, Philadelphia, pp 375–377Google Scholar
  14. 14.
    Lazaridis N, Zouloumis L, Venetis G, Karakasis D (1998) The inferiorly and superiorly based nasolabial flap for the reconstruction of moderate-sized oronasal defects. J Oral Maxillofac Surg 56(11):1255–1259CrossRefGoogle Scholar
  15. 15.
    Merick F (2000) The nose. In: Coleman JJ III (ed) Plastic surgery, vol III. Mosby, St LouisGoogle Scholar

Copyright information

© The Association of Oral and Maxillofacial Surgeons of India 2019

Authors and Affiliations

  1. 1.Dublin Dental University Hospital & Mater HospitalDublinRepublic of Ireland
  2. 2.Northampton General HospitalNorthamptonUK

Personalised recommendations