Rhinectomy (surgical removal of the nose) often occurs as a necessary treatment in the eradication of malignant neoplasms (skin cancers) such as basal cell or squamous cell carcinomas or malignant melanomas.
Malignant tumors or mucormycosis, a fungal infection of the nose, may also arise in the bone or the sinus cavities near the nose requiring surgery to remove the nose. Mohs surgeons, head and neck surgeons, and plastic surgeons often refer patients to us to consider a prosthetic nose or a partial nasal or midfacial prosthesis.
A nose prosthesis can also correct saddle nose deformity which is sometimes caused by nasal granulomatosis, formerly called Wegener’s granulomatosis. A nose prosthesis is also an appropriate prosthetic replacement of the nasal tissues following trauma such as bite wounds or gunshot wounds or motor vehicle accidents (MVAs). We also make nasal prostheses for the correction of defects secondary to chronic substance abuse or for other acquired nasal deformities.
Learn about how we can create custom nose prosthetics for you.
Jeremy's Story
Jeremy
In December of 2006 I was involved in a very serious motor vehicle accident. I had several broken bones and spent two weeks in a coma. The most significant damage was the loss of my nose. Broken bones heal, but this was very permanent. A microvascular surgeon did try to reattach it. However, the attempt was not successful. After getting over the shock of a part of my face being missing, I began to start the process of regaining what was lost. We met with two plastic surgeons and both agreed the damage was too great to repair surgically. My wife began to research other avenues; she came across the web site for Medical Art Prosthetics, and printed off the pictures to show me. When she first told me about it I was very skeptical. Then she showed me the pictures and I could not believe my eyes.
It did seem very strange to have someone make me a nose, but I was willing to look into it. I met with the plastic surgeon one last time hoping his opinion had changed, but still he thought a prosthetic would be best. I asked him for a reference and he said he had seen Mr. Gion’s work and was very impressed. I trusted him and knew the next step was getting in contact with Medical Art Prosthetics. After speaking with Mr. Gion’s partner; clinical anaplastologist Allison Vest, we made the appointment to fly down to Dallas. Our first appointment they showed me the types of product they use and explained the whole process. We decided this was going to be the route we would take. In that same trip we met with Dr. Ellis to talk about getting magnetic implants put in to hold the prosthetic on more secure.
Mr.Gion and Dr. Ellis agreed I was a candidate for the implants. The next trip was to make the impression. He also made a wax nose to give me some idea of what it would look like. That sealed the deal. I was amazed at the wax model; I could not imagine how good the final silicone product would look. As soon as we could we scheduled the surgery to have the implants put in. Recovering from the surgery took about two days. Then we had to wait. It takes three months to let the magnets set in the bone. Right at three months we went down again to finish the process. Dr. Ellis agreed the magnets were secure and Mr. Gion began perfecting the prosthetic. This process took about a week. We spent several hours getting the coloring and shape to be me. Mr. Gion made sure I was 100% satisfied before we flew home. Flying home was a totally different experience; my self confidence had been restored. When we got home it was Christmas time, and my family was beyond words. I have since then gone back to my active life style and I enjoy life again. I am very grateful to Mr. Gion, Ms. Vest and Medical Art Prosthetics for giving me back something no one else could.
Quality Matters in Nasal Prosthetics
Our design sessions to create your nose prosthesis are comfortable, because our specialized environment is quiet, relaxed and conducive to the unique creative technical process. As medical artists and anaplastologists we thrive in these optimal conditions that result in high quality prosthetic outcomes. Many patients visit us from other countries for the unique process and quality nasal prostheses you see in our galleries. We can create for you a life-like, natural-looking new nasal prosthesis to wear with confidence.
Frequently Asked Questions
We can complete many types of total or partial nasal prostheses in 2 or 3 days if you want to come and stay near our office. If we select a more complex attachment system, it might require just an extra day or two. Otherwise, you can arrange to make separate visits. We are very flexible and will create a plan that works for you. (The magnetic types that attach to bone-anchored posts take longer because of osseointegration time which is 2-3 months)
No. A lifelike silicone prosthesis is not implanted under your skin or attached to your body permanently. Even if it is a bone-anchored (osseointegrated) prosthesis– it must be taken off regularly to be washed and to maintain the cleanliness and health of your skin.
- The prosthetic nose can be retained with adhesive strategies we employ for each client, or adhesive-free methods including anatomical fit, magnetic attachment to abutments or dental devices, or by attaching the prosthesis to glasses.
- Midfacial nasal prostheses are attached with adhesives, by a gentle anatomical fit, magnetic attachment to maxillary implants or dentures, or by attaching the nose prosthesis to glasses.
- Partial prostheses to restore the tip of the nose, columella, or the ala (nostril parts) are attached using adhesives or by gently fitting like a puzzle piece into existing anatomy.
We go over all the methods that will work best for you, including osseointegration. Your doctor will help determine if osseointegration is appropriate. Your preference counts the most, but we make the decision together.
Osseointegration is when small screws fixated into bone act as permanent anchors for the prosthesis. Surgeons we collaborate with place the fixtures, then we use the magnetic components that attach the prosthesis to the fixture posts (abutments). We have been refining osseointegration attachment to orbital, nasal, and auricular prostheses since 1984.
In general, we recommend that you remove your prosthesis at night for cleaning and to allow your skin to breathe. Some patients then learn from experience that they can adjust their wearing schedule. We provide personalized wear and care instructions for each client.
Almost all silicone prostheses are washed daily using isopropyl alcohol, detergent soaps like Dawn or Dove, and then rinsed, and kept dry when not in use. However, each prosthesis is unique and might require special precautions. Ultimately, we will walk you through your daily care plan and provide specific instructions tailored to your unique prosthesis.
The cost of a prosthetic nose will depend on your specific condition and the wide range of attachment options appropriate for you, including osseointegration. Adhesive retained nasal prosthesis, anatomically retained prosthetic nose, glasses-retained midfacial prosthesis, and the bone anchored magnetic nose prostheses all have different treatment plans, complexity, and associated costs.
It is possible that your insurance will cover some or all the costs. After we receive your permission and insurance information our insurance specialist will help determine the level of coverage of your insurance plan.
The medical and insurance community often say 2 or 3 years is the average lifespan of a silicone nasal prosthesis. Insurance might then pay for a replacement. Many of our patients wear the original prosthesis for several more years with an occasional retinting. Identical replacement prostheses are then available from the original mold taking just a day or two and at substantially less cost to you.
These activities will not hurt the prosthesis. However, vigorous movements and/or sweating could affect the bond/security of adhesive-retained prostheses. We recommend wearing your prosthesis at home at first during strenuous type activities to become familiar with the strength of the prosthesis attachment.
We do not recommend sleeping with the prosthesis on – at least not on a regular basis. This is for maximum longevity of your prosthesis’ surface finish and for the health and hygiene of your skin under the prosthesis, especially for implant-retained nasal and maxillofacial prostheses.
Infection rates around these abutments may be found in the literature. Two sample references for you:
Long-term outcomes of craniofacial implants for the restoration of facial defects Int. J. Oral Maxillofac. Surg. 2018; 47: 773–782 https://doi.org/10.1016/j.ijom.2018.01.013 https://www.sciencedirect.com
Survival and complications of implants to support craniofacial prosthesis: A systematic review. Journal of Cranio-Maxillofacial Surgery Volume 44, Issue 10, October 2016, Pages 1536-1552 https://www.sciencedirect.com/science/article/abs/pii/S1010518216301664
I hope this information helps in getting comfortable with the decision to have an ear prosthesis, whether it is a slip-on anatomical fit, attached with adhesive, or is the implant-retained type.
When you decide to have a prosthesis, it then becomes important to ask questions about the practitioner who will create and fit your prosthesis. We recommend critiquing the accuracy and aesthetics of a series of case results. When you see samples of accurately detailed and carefully crafted ear prostheses is an indicator that the practitioner has specialty experience in comprehensive ear prosthetics care. Pre-treatment planning, prosthesis design, patient education in proper hygiene, and follow-up care all promote maximum success in nasal prosthetics.
