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The aim of reconstructive nasal surgery is not only to rebuild all or part of the nose but also to blend and tailor the new and old tissues in such a way as to create the best possible result. Although a variety of reconstructive options exist, local or regional skin flaps are one of the most powerful reconstructive tools for the reconstruction of cutaneous nasal defects. This article discusses the fundamentals of nasal reconstruction and describes the local and regional transposition flaps for the reconstruction of nasal defects.