A long time ago I promised to explain how I would 'fix' Michael Jackson's nose. Well, if it has been operated on as many times as I think it has, his nose is now a scarred-up mess.
The best way to recontruct a nose like his would be to treat it like a cancer reconstruction. We can remake the soft tissue (skin and fat) of a nose by transferring the skin from the forehead down to the nose. This entails two surgeries. During the first surgery we lift up the skin of the forehead (into a shape to fit the nose) and swing it down to what's left of the nose. We temporarily keep the skin attached to the forehead, where the blood vessels continue to supply blood to the transferred skin. This connection is left for about 3 weeks, to allow new blood supply to develop from the nose to the new transferred forehead skin.
Yes, for three weeks the person walks around with the skin of the forehead attached via a 'bridge' to their nose. It's a pretty strange sight.
After these three weeks, the patient goes back to surgery, where the connection is divided at the forehead and the skin is 'inset' into the nose, giving him a new, softer, larger nose. Now, Michael may also need some nasal support if a good portion of his cartilage and/or bone has been removed. This would likely entail grafts of bone or cartilage from his ribs, a somewhat painful procedure I rarely perform.
The "Paramedian Forehead Flap" is probably the best way to take today's Michael back to the 80's Michael. During the time of his healing, he would be no PYT.
Photo credit: prphotos.com
For more information on the Paramedian Forehead Flap, click here.
Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.
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