Paramedian forehead flap combined with hinge flap for nasal tip reconstruction

Abstract

The paramedian forehead flap is a great option for restoration of complex nasal defects. For full-thickness defects, it may be used alone or in combination with other methods. We present a patient with a basal cell carcinoma on the distal nose treated by Mohs micrographic surgery, and a resulting full-thickness defect repaired with paramedian forehead flap combined with a hinge flap. For optimal results with the paramedian forehead flap, adequate surgical planning, patient orientation and meticulous surgical technique are imperative.

Surgical Techniques Following Free Cartilage Grafting

“…Thirty-four studies describing 723 surgical defects in 713 patients were included in the literature review (See Supplemental Digital Content , Table S2 , http://links.lww.com/DSS/B108). 1–33 The mean age of patients was 63.3 ± 10.4 years. Free cartilage grafts were most commonly harvested from the ear (93.1%).…”

“…23 Conchal bowl cartilage is preferred by some surgeons because of its natural concavity that matches the native ala, and its elasticity and high degree of memory. 3,7,10,14,22,23,25 An anterior harvesting approach allows for easy accessibility, ease of donor site repair, and the ability to hide the donor site within the concavity of the conchal bowl, whereas a posterior approach is sometimes favored because the donor site scar is well-concealed. Other surgeons prefer to harvest antihelical cartilage for isolated alar defects because it is less brittle and more easily harvested than the conchal bowl cartilage.…”

“…4,8 Harvesting ipsilateral ear cartilage is generally preferred because of the advantage of limiting patient repositioning during reconstruction. 23 Conchal bowl cartilage is preferred by some surgeons because of its natural concavity that matches the native ala, and its elasticity and high degree of memory. 3,7,10,14,22,23,25 An anterior harvesting approach allows for easy accessibility, ease of donor site repair, and the ability to hide the donor site within the concavity of the conchal bowl, whereas a posterior approach is sometimes favored because the donor site scar is well-concealed.…”

Single-stage acellular dermal matrix reconstruction of defects in the nose and ears with exposed cartilage: a prospective case series

“…Traditionally, locoregional and paramedian forehead flaps are the primary options for the reconstruction of wounds located on the distal nose [1,12]. Many different surgical techniques are described in Western studies that attain good results, but retraction and scars associated with rhinoplasty are more frequent in Asia [13][14][15].…”