Suitable age for nasal reconstruction after subtotal amputation in a child, with respect to a case involving purpura fulminans.

The authors report a case of nasal reconstruction in a 5-year-old boy who had undergone subtotal amputation of the nose 8 months before in the context of meningococcus-induced purpura fulminans. Two-step surgery involved implantation of a forehead expansion graft preliminary to use of a contralateral forehead flap to cover a cartilaginous graft from the concha that reconstituted the ala nasi, columella, and septum. At 1 year of follow-up, the results were considered quite satisfactory esthetically and psychologically beneficial. Nasal amputation in the child is infrequent, and the procedure is not clearly defined. Early reconstruction certainly improves the child's life and social integration. The major risk is unsatisfactory growth of the reconstructed nose, which may persuade some surgeons to postpone the operation.