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About the Book

Aesthetic Nasal Reconstruction Principles and Practice

Aesthetic Nasal Reconstruction Principles and Practice is the latest two-volume textbook from Frederick J. Menick, M.D., the world's leading authority on nasal reconstruction.

The most comprehensive nasal reconstruction book ever published, Aesthetic Nasal Reconstruction Principles and Practice includes hundreds of cases — from simple to complex and small to large defects — plus 6,500+ step-by-step pre-, intra-, and post-op images.

Aesthetic Nasal Reconstruction Principles and Practice by Frederick J. Menick, MD


Defects vary, but The Normal never changes — it remains the perpetual goal of aesthetic reconstruction. 

Training and experience — no matter how good  do not provide solutions for each and every potential defect or problem you may encounter. In the quest to achieve an aesthetically-pleasing result, the path to restoring The Normal isn't obvious, nor is it easily navigated. This is the plight of the reconstructive surgeon.

So, how can we set ourselves up to achieve consistently good results when we're presented with consistently challenging and different defects?


You need principles — applicable to every defect — to guide your surgical decisions about timing, materials, methods, and stages. 

“The real value lies in their truths — from which answers can be derived, by logic, for any variety of problems — rather than depending on memorized blueprints, which may not be accurately recalled or, if so, may not be applicable.”  

– Ralph Millard, M.D.

Success in aesthetic nasal reconstruction is earned through careful planning and deliberate choices, not through dependence on any one surgical maneuver.  

Planning is paramount, and the best plans are derived from understanding and practicing the tried-and-true principles outlined in Aesthetic Nasal Reconstruction Principles and Practice.

In this two-volume set, Dr. Frederick Menick shares invaluable lessons from his 35-year clinical practice as well as the secrets of his pioneering techniques. 

Based on a principled approach to repair, you’ll learn how to:

  • Know the Normal
  • Analyze a defect and formulate a solid approach to reconstruction, based on fundamental principles
  • Define the "true" tissue loss to determine what is missing and what is present, plus evaluate what tissues are available and appropriate to make what you want
  • Set priorities and develop a plan
  • Prepare the wound, patient, and surgeon for success
  • Design operative templates to replace tissues accurately
  • Replace missing cover, lining, and support
  • Employ secondary healing
  • Use forehead skin grafts for nasal resurfacing
  • When and how to use local flaps
  • Choose between nasolabial and forehead donors
  • Use a 2- and 3-stage forehead flap (indications and techniques)
  • Handle the forehead donor site primary closure, expansion, surgical delay, harvesting a second or third or fourth flap
  • Design and position cartilage support
  • Correct initial errors and imperfections before pedicle division
  • Avoid and treat complications, such as intraoperative problems, postoperative cover and lining necrosis, and infection
  • Revise an imperfect result or re-do a failed reconstruction
  • Use microvascular free flaps for nasal reconstruction
  • Restore a normal appearance with minimal scarring

Table of Cases

A photographic Table of Cases provides a quick reference to the book's contents. Hundreds of defects — covering the full scope of nasal reconstruction with variability in size, site, outline, depth, and adjacent midface injury — are photographically illustrated within the Table of Cases.

Simply identify a defect similar to the case before you — whether due to trauma, cancer excision, immune disease, infection, a prior failed reconstruction, etc. — and be directed to the solution within the text.

Table of Contents

The Table of Contents directs the reader to comprehensive chapters, which discuss the aesthetic replacement of missing cover, lining, and support  applicable to small and large, simple and complex deformities.

The history, indications and contraindications, technical details, and results are described for hundreds of cases, alongside 6,500+ photographs.

Because problems inevitably arise, specific chapters discuss how to deal with complications, perform a revision of an imperfect repair, or redo a failed repair with another regional flap.

Chapter 1 Purpose: What Is a Nose and Why Do We Reconstruct It?
Chapter 2 Principles of Aesthetic Facial and Nasal Repair: Old vs. New
Chapter 3 Preoperative and Operative Planning
Chapter 4 Planning for Skin Cancer Repair
Chapter 5 Planning for Composite Defects That Extend Into the Lip and Cheek
Chapter 6 A Case Study Principles and Planning
Chapter 7 Introduction to Restoring Skin Cover
Chapter 8 Repairing Small, Superficial Defects
Chapter 9 Repairing Large, Deep Defects
Chapter 10 The Nasolabial Flaps
Chapter 11 2- and 3-Stage Forehead Flaps
Chapter 12 The Paramedian Forehead Flap Technical Details
Chapter 13 Case Studies in Forehead Flap Reconstruction
Chapter 14 Managing the Forehead Donor Primary Closure, Expansion, Delay, Multiple Harvests
Chapter 15 Introduction to Restoring Lining
Chapter 16 Advancement of Residual Nasal Lining
Chapter 17 Composite Skin Grafts
Chapter 18 Prelaminated Lining
Chapter 19 Hingeover Lining
Chapter 20 Using Two Flaps to Line and Cover the Nose
Chapter 21 Intranasal Lining Flaps
Chapter 22 Folding a Full-Thickness Forehead Flap for Lining
Chapter 23 Case Studies Folded Forehead Flap for Lining
Chapter 24 Skin Grafts for Lining
Chapter 25 Microvascular Flaps for Lining
Chapter 26 Restoring Hard and Soft Tissue Support
Chapter 27 Primary Intranasal Lining Loss Trauma, Immune Disease, Cocaine Injury
Chapter 28 Columellar Reconstruction
Chapter 29 Dealing With Complications
Chapter 30 Revising an Imperfect Nasal Reconstruction
Chapter 31 A Case Study in Late Revision
Chapter 32 Redoing a Failed Nasal Reconstruction
Chapter 33 Achieving Precision and Patience


The latest release from Frederick J. Menick, M.D. is an essential resource for any surgeon who closes facial defects and seeks to deeply understand as well as successfully execute superior results.

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