A regenerative approach to facial surgery is offering new hope for restoring form and function for people who’ve suffered facial trauma or skin cancer. Skin cancer is the most common form of cancer in the United States, according to the Centers for Disease Control and Prevention (CDC). And for patients with skin cancer on the head or face, surgery can lead to scarring, disfigurement or loss of function. This is especially true for the nose, which is the most common location for skin cancer, and surgery may be the most effective treatment. Brittany Howard, M.D., a Mayo Clinic otolaryngologist and surgeon at Mayo Clinic’s Arizona Campus, is pioneering a new regenerative application for these patients.
“Historically, patients who’ve had surgery to treat cancer may require total removal of the nose. Even with the most advanced surgical techniques, patients were left with a nose that was passing aesthetic, but often nonfunctioning,” says Dr. Howard. “We take for granted the ability to breathe through our nose and the personal physical identity it provides.”
A standard approach is to build a “new” nose using skin transplanted from elsewhere on the body, such as a patient’s wrist. However, because the transplanted tissue includes the skin, which is not normally present within the nose, there can be breathing issues over the long-term.
As a facial plastics and reconstruction surgeon that also specializes in head and neck cancer, Dr. Howard is interested in total nasal reconstruction that not only looks good, but also restores the ability to breathe normally through the nasal passages.
Dr. Howard specializes in a new method of reconstructing the nose that involves using tissue transplanted from an individual’s leg to create a new nasal skeleton and nasal lining that more closely matches the natural lining of the nose. In later stages, skin is brought from the forehead to create the external appearance of the nose. The result is both aesthetic and functional.
Because of Dr. Howard’s dual specialty in both cancer reconstruction and facial aesthetic surgery, she naturally developed a passionate interest in complex nasal reconstruction that addressed both the function and the aesthetics of the nose.
“Beyond treating a cancer, I believe that an individual should be restored to their prior state of form and function,” says Dr. Howard. “At Mayo Clinic, through the Center for Regenerative Medicine, I am able to combine regenerative medicine science with reconstructive and aesthetic surgery techniques to offer my patient’s state-of-the-art reconstruction goals.”
To complement this work, Dr. Howard and her team are researching the use of selective fat grafting in nasal reconstructions. Mainly used for facial rejuvenation, traditional fat grafts restore volume. However, fat is also rich in stem cells that can stimulate wound and tissue healing. This research could be used in nasal reconstruction where nanofat grafts (that contain optimal levels of stem cells) can be used, not for volume, but instead to affect tissue healing and final outcomes.
This pioneering surgery is offered in patient care at Mayo’s Arizona campus.