What is eyelid, ear and nose reconstruction?
Eyelid, ear and nose reconstruction is the plastic surgery that restores the skin, cartilage support and inner lining of these three facial units when they have been damaged or lost. The most common cause in Mexico is the removal of a skin cancer —basal-cell or squamous-cell carcinoma, both very common on the face from sun exposure— which leaves an open defect; next come traumatic injuries (accidents, burns, dog bites to the ear or nose) and congenital defects such as microtia (an underdeveloped ear present from birth).
It differs from cosmetic surgery because the starting point is not a healthy feature to be improved, but missing tissue that must be replaced. Each of these areas is its own challenge: the eyelid is a structure only millimetres thick whose job is to protect and lubricate the eye; the nose combines skin, cartilage and mucosa in three layers on which breathing depends; and the ear is a delicate cartilage framework covered by thin skin. Rebuilding them requires respecting both function —lid closure, airway, ear contour— and appearance, so the result does not betray the surgery.
Techniques used by Dr. Arístides Arellano
There is no single operation to reconstruct the face: the right technique depends on which unit is being rebuilt, the size and depth of the defect and which layers are missing (skin, cartilage or lining). Dr. Arístides Arellano chooses the simplest option that solves the case, following the so-called reconstructive ladder:
- Local flaps: healthy neighbouring skin, with its own blood supply, is moved to cover the defect with tissue of identical colour and texture. It is the mainstay of eyelid reconstruction and of many nasal and ear defects.
- Skin grafts and composite grafts: when there is not enough neighbouring skin, skin (or skin with cartilage, for the ear rim or the nasal ala) is taken from a donor site such as the ear or the area behind it.
- Cartilage grafts: cartilage from the septum, the ear or the rib to rebuild the support of the nasal ala, the tip or the ear framework, preventing collapse of the airway.
- Paramedian forehead flap for large nasal defects: skin from the forehead rotated onto the nose in two or three stages, the reference technique for rebuilding entire nasal subunits with quality skin.
- Tarsoconjunctival (Hughes) flap and layered eyelid reconstruction: rebuilding the eyelid in its two lamellae —anterior (skin-muscle) and posterior (tarsus-conjunctiva)— to restore closure and protect the eye.
- Ear reconstruction with a costal cartilage framework for microtia or traumatic loss of the ear: a framework is carved from rib cartilage and covered with skin over several stages.
How is it performed?
Reconstruction is carried out after analysing the defect layer by layer: what skin, cartilage and inner lining are missing, and which neighbouring structures can be borrowed to repair it. When the defect comes from a skin cancer, it must first be confirmed that the margins are free of tumour —ideally with Mohs surgery or pathology— before closing; reconstructing over residual tumour is a serious error. Anaesthesia may be local with sedation for small defects, or general for extensive reconstructions and in children.
Depending on the case, the repair is done in a single stage or in stages: forehead flaps for the nose and ear reconstruction with rib cartilage require two or three surgeries spaced weeks or months apart, because the tissue must integrate and mature before the next step. It is normal for the result to be judged at six to twelve months, when scars fade and the contour settles; a minor touch-up may be needed to refine the result. It helps to understand this from the start: in reconstruction, patience is part of the treatment.
All surgery carries risk and requires a prior medical assessment. Results may vary according to each patient, their anatomy and their individual healing process.
Who is a good candidate?
- People with a defect after removal of a skin cancer on the eyelid, ear or nose, once it is confirmed the margins are free of tumour.
- Patients with traumatic injuries —accidents, burns, bites— who have lost skin, cartilage or part of one of these facial units.
- Children and adults with microtia or another congenital defect of the ear, nose or eyelid, assessed at the right point in their development.
- Those with a functional problem —ectropion or poor eyelid closure, nasal airway obstruction, absence of an ear framework— in addition to the aesthetic defect.
- Patients in good general health with realistic expectations, willing to undergo treatment that may require several stages and months until the final result.
Recommended post-surgical care
After reconstruction, care of the scars and flaps is as important as the surgery itself: the area is strictly protected from the sun, the sutures and dressings are cared for as instructed, and —once the tissue has healed— silicone sheets, massage and scar treatments may be used to improve appearance. In staged reconstructions, each check-up confirms the tissue is ready for the next step. See the full guide: Post-surgical recovery and care.
Before and after
Most patients want to see before-and-after photographs before deciding. Out of respect for each person’s privacy, Dr. Arístides Arellano shows real cases —always with documented consent— during your in-person consultation, where you can review results from patients with a starting point similar to yours. Results may vary from patient to patient.
Approximate price
The price of an eyelid, ear or nose reconstruction has no flat fee because every defect is different: closing a small eyelid defect with a local flap does not cost the same as rebuilding a whole ear with rib cartilage in three stages. It is therefore set at the consultation, after examining the defect and planning the technique and number of stages, with a written quote; be wary of anyone who quotes a reconstruction without seeing the lesion. Approximate price — the definitive cost is set at your private consultation with Dr. Arístides Arellano. See the price list.
About Dr. Arístides Arellano
Dr. Arístides Arellano is a plastic surgeon holding a specialty licence: he practises under a Mexican medical licence (D.G.P. 1125959) and a specialty licence in Plastic & Reconstructive Surgery (0002008), both issued by the Directorate General of Professions (DGP), which reissued his certificate of professional standing in 2025. His career began before Mexico’s present-day specialty-board system existed: he belongs to the founding generation of plastic surgery in Puebla, the second generation of a surgical tradition started in 1971 by Dr. Francisco Arellano Ocampo. Trust is verified, not promised: both licences are public and anyone can look them up in the DGP’s National Registry of Professionals.
Related patient guide
Choosing the right person to reconstruct your face is the most important decision in the process. Before your consultation, read how to choose a plastic surgeon in Puebla, with the questions worth asking and the red flags to avoid.
Trust is verified, not promised. All 210 scanned documents —degree, licences, diplomas, publications and certificates, from 1977 to 2025— are open in Dr. Arístides Arellano’s credential archive, alongside an explanation of the difference between a specialty licence and a board certification.
Recovery · step by step
- Days 1–7Swelling and bruising in the area; dressings and strict protection. External sutures are usually removed around days 5 to 7 on the face.
- Weeks 2–3The main swelling subsides. The scar is still red and firm; social life resumes with the area protected from the sun.
- Weeks 4–8In staged reconstructions, the next surgical stage is scheduled (forehead flap, cartilage). The tissue matures.
- Months 3–6The scar begins to fade and soften. Silicone sheets and massage are considered; the contour becomes defined.
- Months 6–12Definitive result, when scars pale and the contour settles. A minor touch-up may be considered to refine.
Frequently asked questions
What is eyelid, ear and nose reconstruction?
It is the plastic surgery that restores the skin, cartilage and lining of these areas of the face when they have been damaged or lost, almost always after removal of a skin cancer, a traumatic injury or a congenital defect such as microtia. Its goal is to close the defect, protect function (the eye, breathing, hearing) and rebuild a natural contour.
How does it differ from cosmetic surgery?
Cosmetic surgery improves a healthy feature; reconstruction replaces missing tissue. The starting point is a defect —an open wound after removing a tumour, an unformed ear, a nose damaged in an accident— and the priority is function first, then appearance. It is often planned in several stages and the result is judged over months.
Is reconstruction done in a single surgery?
It depends on the defect. Small defects are closed in a single stage with a local flap or a graft. Large reconstructions —a forehead flap for the nose or a whole ear with rib cartilage— require two or three surgeries spaced weeks or months apart, because the tissue must integrate before the next step. The exact plan is set at the consultation.
Can the nose or eyelid be reconstructed after skin cancer?
Yes, and it is one of the most common reasons to operate. It must first be confirmed that the tumour margins are clear —ideally with Mohs surgery or pathology— and then the defect is reconstructed with local flaps, grafts or cartilage depending on its size. Reconstructing over residual tumour is an error, which is why the order matters.
At what age is microtia (an unformed ear) operated on?
Ear reconstruction with rib cartilage is usually considered when the child has enough cartilage to carve the framework, typically from around six years of age. The exact timing and technique are assessed individually, considering the child’s development and whether hearing is affected.
Are there scars?
Every reconstruction leaves scars, but they are planned to hide them in the natural folds and edges of each facial unit and cared for afterwards with strict sun protection, silicone sheets and massage. Over time they pale and soften; the scar result is judged at six to twelve months. Results may vary from patient to patient.
How much does facial reconstruction cost in Puebla?
There is no flat fee because every defect is different: a local flap on an eyelid does not cost the same as rebuilding a whole ear in three stages. The price is set at the consultation, after examining the defect and planning the technique and number of stages, with a written quote.
Every case is different. Discuss yours in a personal consultation.
Book a consultation on WhatsAppEvery figure published on this site is approximate and is not a quote. Any procedure or treatment first requires a private assessment consultation with Dr. Arístides Arellano —$800 MXN, charged separately— and it is at that consultation that the definitive cost of your case is determined.
Educational content; it does not replace a medical consultation. Results may vary from person to person.