Complete Nose Reconstruction Restores Man’s Confidence After Amputation

Andrew Koplove, 37, is a fun-loving guy who enjoys the outdoors — bicycling, snowboarding, kayaking and spending time on the water.

In 2017, Andew’s job as a medical device engineer took him from his home in Massachusetts to the San Francisco Bay Area of California. That year, an attack by a dog resulted in the amputation of Andrew’s nose.

After the initial medical care he received, Andew moved back to Massachusetts. He essentially had a flat face, with two healed holes where his nose had been. Whenever he left his house, he would bandage his nose area.

Andrew spent the next 18 months researching plastic surgeons; he wanted to receive the best care possible. “Choosing the best doctor really mattered to me. Many renowned surgeons told me that surgeries would result in me being permanently deformed, and I didn’t want to settle with that. I believed there had to be a better option,” recalls Andrew.

An attack by a dog in 2017 resulted in the amputation of Andrew's nose. Side view, before (left) and after (right) Andrew's nasal reconstruction. 

Through his internet research, Andrew found plastic surgeon Patrick Byrne, MD, Chief of the Integrated Surgical Institute and Chair of Otolaryngology - Head and Neck Surgery at Cleveland Clinic. At that time, Dr. Byrne was practicing at another hospital. “I didn’t really have any hope during that time of my life until I met Dr. Byrne. He gave me hope that I would have an excellent result with no lasting noticeable deformities,” says Andrew.

Andrew flew back and forth for his surgeries. When Dr. Byrne began practicing at Cleveland Clinic in 2020, Andrew moved to Columbus, Ohio, to be closer to his healthcare provider.

Cleveland Clinic's Center for Facial Reconstruction and Facial Nerve Disorders cared for Andrew. The Center brings together multiple experts from different disciplines to provide leading-edge reconstructive technology and expertise with an unparalleled success rate. This collaboration brings patients the best care — from consultation to surgery to rehabilitation.

“I had two of the bests in the world, Dr. Byrne and Cleveland Clinic. I was confident in both of them and that I’d have a fantastic outcome. I knew both could handle any challenges,” says Andrew.

Over the span of four years and 14 surgeries, Andrew underwent a complete nose reconstruction with Dr. Byrne and his team.

“There is no such thing as a simple nasal reconstruction — typically, the larger the defect, the more complicated the case. A total nasal reconstruction is a difficult plastic surgery endeavor,” says Dr. Byrne. “But, I was confident we could create a new nose for Andrew.”

Andrew spent 18 months researching plastic surgeons before choosing Dr. Byrne. Above, Andrew is shown before nasal reconstruction and mid-reconstruction.

Andrew’s nose was built almost entirely from scratch using his own tissue — cartilage from his ribcage, cartilage and skin from his ear, and tissue from his forehead for the external skin.

It was reconstructed in three layers. The internal layer needed to be thin and vascular. The middle layer, which is the structural layer, is composed of cartilage and bone. This layer, often referred to as the subsurface framework, essentially needs to be a three-dimensional sculpture that looks like a nose — but slightly miniaturized. The third layer – the external layer of skin — used skin taken from the forehead because it’s an excellent match in terms of tissue color and characteristics in most patients.

Andrew’s surgical journey had a little bit of a twist — he suffered postoperative complications due to an infection. The infection resulted in dissolution of much of Andrew's subsurface cartilage framework.

“I’ve learned over the years to take these early complications very seriously and act quickly whenever possible. Ultimately, we had to complete a second forehead flap to achieve an acceptable outcome,” says Dr. Byrne.

With time and multiple surgeries, Dr. Byrne and his team created an aesthetically pleasing and functional nose for Andrew.

“Andrew is an inspiration. He managed adversity and handled setbacks all with consistent grace,” says Dr. Byrne.

Andrew didn’t plan to stay in Ohio once his surgery was complete, but he’s changed his mind. He enjoys exploring his new home state and seeking out new adventures. He sees Dr. Byrne as needed.

Andrew after healing from his nasal reconstruction surgery. 

“Before my nose reconstruction, I lost a lot of myself. People would stare or ask me what happened. It was extremely uncomfortable,” remembers Andrew. “Your face and aspects of your face are your identity and I lost that. I wouldn’t be who I am today without Dr. Byrne. He gave me my life back and the confidence to be myself again, go on dates, meet new people and feel confident in everything I do.”

Andrew wants others who face similar traumatic injuries to trust the process, trust Dr. Byrne, and never lose hope. “Dr. Byrne and his team can truly make miracles happen,” says Andrew. “I am so, so grateful for all that they've done for me.”