This session will concentrate on the latest developments in nasal reconstructive surgery, focusing specifically on the more complicated end of the spectrum. It will cover salient issues related to total internal lining reconstruction, three stage folded forehead flaps, internal skeletal reconstruction including autogenous and allogenic materials, osteocartilaginous rib, auricular and calvarial grafting materials, as well as microvascular reconstructive paradigms. Extensive case experiences with clear photographic documentation, as well as recommendations for reconstructions performed both before and after radiation therapy will be discussed. Learning Objectives: 1. Explain the options for skin coverage for total and subtotal nasal reconstructions. 2. Summarize the advantages and disadvantages of autogenous v allogenic and cartilaginous v osseous materials. 3. Review the balance of thickness, strength, and contraction forces in nasal reconstruction.Faculty: Michael Fritz, MD(Nothing to Disclose), Rahul Seth, MD(Research funding: Bard Davol), Andrea Park, MD(Nothing to Disclose), Daniel Knott, MD(Nothing to Disclose).