This article is a review of five patients who underwent reconstruction of n
asal and paranasal facial defects with prelaminated forearm free flaps. The
defects resulted from thermal injury, gunshot wound, excision of tumor, an
d arteriovenous malformation (n = 2). The forearm flaps were based on the r
adial artery (n = 4) and ulnar artery (n = 1) and were prelaminated with gr
afts of skin and cartilage. All flaps were successfully transferred to the
face, but revisions were needed to separate the subunits and improve appear
ance. A prelaminated free flap should be considered for a patient requiring
reconstruction of a complex central facial defect.