The forehead flap for nasal reconstruction

Context: Reconstruction of extensive nasal defects often represents a signi ficant challenge owing to several unique qualities of the nose, such as com plex topography, mobile free margins, and multiple nasal subunits. Furtherm ore, loss of internal nasal lining and/or structural skeletal support may b e present following removal of extensive skin cancers. Objective: To describe our experience with the use of forehead flap reconst ruction for extensive nasal defects. Design: Retrospective case series. Setting: Academic health care hospital system. Patients/lntervention: One hundred forty-seven patients with extensive nasa l defects repaired with a forehead flap. Main Outcome Measures: The functional and aesthetic results were assessed. The characteristics of defects repaired with the forehead flap and the need for lining and/or cartilage were examined. Results: The forehead flap was used to repair 147 nasal defects after Mohs excision of nonmelanoma skin cancer. Full-thickness skin was lost in all ca ses, structural skeletal support in 68 cases (46%), and internal mucosal li ning in 45 cases (31%). Our experience and surgical technique using the for ehead flap are described. Conclusions: The forehead flap represents one of the best methods for repai r of extensive nasal defects. Near-normal functional and cosmetic results c an be achieved.