Refinements in nasal reconstruction: the cross-paramedian forehead flap

Plastic and Reconstructive Surgery
Jeff Angobaldo, Malcolm Marks

Abstract

Nasal reconstruction can be a challenge for the plastic surgeon. The forehead flap is the workhorse in nasal reconstruction, providing similar skin color, texture, structure, and reliability. There are disadvantages of the forehead flap, including a difficult arc of rotation, which risks displacement of medial eyebrow hair. The vertical design can encroach on the scalp, incorporating hair into the nasal reconstruction. Forehead flap inset results in an inverted V-shaped scar visible in the glabella region. This article describes the authors' modification of the established oblique paramedian forehead flap. This retrospective study included a consecutive series of patients over an 11-year period (December of 1996 to December of 2007) that underwent nasal reconstruction performed by the primary surgeon (J.A.). Information obtained from chart reviews included age, sex, cause of nasal defect, complications, and revisions. This study population consisted of 94 adults: 54 men (57 percent) and 40 women (43 percent) who underwent nasal reconstruction using the cross-paramedian forehead flap. All flaps were performed for skin cancer reconstruction. Partial flap loss was the most common complication. Tobacco use was associated with half ...Continue Reading

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