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Nasal reconstruction occupies a special position in facial plastic surgery because of the complex three-dimensional surface of the nose, the varying thickness of the skin covering it, its varying types of scaffolding ranging from rigid bone to flexible cartilage, and its inner epithelial lining. Burget and Menick have written a seminal text on functionally and esthetically superior nasal reconstruction (1). Other authors have described particular reconstructive techniques that can be used advantageously to repair defects at certain special sites. There are, as yet, no controlled studies on the quality of nasal reconstruction. The defects are too varied, and the reconstructions, though always based on the same basic principles, allow a great deal of room for creativity on the plastic surgeon’s part. This is an important characteristic of plastic surgery in general that makes it difficult to consider the types of therapy under discussion from the point of view of "evidence-based medicine." Inadequate results are not infrequently seen, particularly with more complex types of nasal reconstruction. Such experiences have motivated the authors to describe in this article, for the general medical public, the types of results that are attainable. In a later issue of the Deutsches Arzteblatt International, another article will appear on the subject of reconstructive surgery of the face, head, and neck.