Elimination of Postburn Dorsal Nasal Contracture
Because of its anatomical location and forward protrusion, the nose incurs more severe burns, especially the alae and dorsum. The nose is shortened, its tip is pulled up, the nasofrontal angle (nasion) is smoothed, and the epicanthus/fold appears at the medial corners of the eyes. Scars in children are especially traumatic due to restriction of nose growth over time. Therefore, the nose contracture should be released early, before reconstruction of the rest of the face. A wide scar in the glabella allows for the nasofrontal angle and medial canthus of eye reconstruction to be performed with local flaps; the preferred technique is trapeze-flap plasty.