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Surgeon creates nose on man’s forehead
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A SURGEON in China’s southeastern Fujian Province says he has constructed an extra nose out of a man’s rib cartilage and implanted it under the skin of his forehead.
He is now preparing for a transplant which is probably the first operation of its kind.
Guo Zhihui at Fujian Medical University Union Hospital spent nine months cultivating the graft for a 22-year-old man whose nose was damaged.
The striking images of the implant — with the nostril section facing diagonally upward on the left side of the man’s forehead — widespread attention in Chinese media this week.
Guo plans to cut the nose from the forehead while leaving a section of skin still connected, and then rotate and graft it into position in a later operation.
“We were just interested in helping the man and did not expect it would stir up this much attention,” Guo said on Friday.
Surgeons previously have used cartilage to help rebuild noses in their proper position and are experimenting with growing new ones from stem cells on other parts of the body, such as a forearm. But this was the first known case of building a nose on a forehead.
The patient lost part of his nose in an accident last year and did not immediately have reconstruction surgery as he couldn’t afford it, Guo said. An infection later ate away much of his nose cartilage, he added.
Alexander Seifalian, a professor of nanotechnology and regenerative medicine at University College London who has worked on transplants using stem cells, said implanting the nose graft in the forehead makes sense because the skin there has the same “structure and texture” as that of a nose.
However, he said it was unclear why the Chinese team built the nose on the forehead rather than in its proper position.
A nose graft grown from stem cells would be prepared on another body part first, but this operation is using existing cartilage, Seifalian said.
Guo said his team examined what remained of the man’s nose after the infection and concluded there was little chance of grafting cartilage there, and instead opted to build the nose on the forehead.
When the nose is rotated into position and grafted, it will at first have a blood supply from links to the forehead, before developing new blood vessels.
The team expanded skin on the forehead for three months before using rib cartilage to build the nose bridge. Lastly, Guo’s team created the nostrils.
“We sculpted the nose three-dimensionally, like carpenters,” he said.
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