We have sought strategies to enhance our ability to successfully reconstruct the human nose. We present one of our efforts to use current technology to improve our ability to accurately create the subsurface framework on which the success of such an endeavor rests. Our novel approach involves the creation of an intraoperative surgical guide, aided by 3-dimensional laser surface scanning and rapid prototyping. This translucent template is developed through cooperative effort by the patient, anaplastologist, and surgeon working together. It is then custom made, sterilized, and available for use during the procedure. It is placed on the patient's face at critical points during the procedure. The subsurface framework is then painstakingly built in a stable fashion to reflect the dimensions and contour of this guide. It is created in such a manner as to anticipate the effect of the thickness of the forehead flap on the final external dimensions.
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