Aesthetic and Functional Outcomes of 2-Stage Versus 3-Stage Paramedian Forehead Flap Techniques

Stahl, Adelana Santos; Gubisch, Wolfgang; Haack, Sebastian; Meisner, Christoph; Stahl, Stéphane

doi:10.1097/dss.0000000000000468

Cited by 12 publications

(17 citation statements)

References 6 publications

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“…Aesthetic results of 3-stage forehead flap technique; in terms of flap thickness compared with the 2-stage technique was not found superior. The 2-stage technique was considered state-of-the-art choice for nasal reconstruction even in complex nasal defects 17 .…”

Section: S173mentioning

confidence: 99%

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Reconstruction of Nasal Ala Defects Using Three Staged Folded Forehead Flap: Aesthetic and Functional Outcomes

Ali

Tahir

Raza

et al. 2021

PAFMJ

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Objective: To assess short and long term aesthetic and functional outcomes of nasal ala reconstruction by three staged folded forehead flap. Study Design: Prospective study. Place and Duration of Study: Plastic and Reconstructive Surgery Department of Combined Military HospitalBahawalpur and Quetta, from Dec 2014 to Dec 2018. Methodology: Total of 29 patients were enrolled through consecutive sampling technique. Nasal ala defects were reconstructed by three staged frontal forehead flap under general anesthesia. Follow up visit at 2 weeks bleeding, wound Infection, partial skin graft loss and partial flap necrosis was documented. Follow up at 24 weeks, functional outcome of nasal reconstruction was assessed by history and clinical examination for nasal obstruction and/or crusting. Patients’ subjective satisfaction about aesthetic outcome of nasal reconstruction was documented on 5 point likert scale. Objective aesthetic assessment of reconstruction was done on 2D photograph by two independent surgeons. Results: Twenty six (89.66%) males and 3 (10.34%) females participated in study. The mean age was 35 yearsrange 16 to 64 years. Follow up at two weeks revealed postoperative bleeding in 2 (6.8%), wound infection in 1(3.4%) and partial flap loss in 1 (3.4%) patient. At 24 weeks follow up all patients had patent nasal ala. Subjectiveand objective assessment of nose shape was documented. Conclusion: Use of three staged folded forehead flapis useful method of reconstruction for full thickness defects of nasal alaewith good functional and aesthetic outcome.

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Section: S173mentioning

confidence: 99%

“…Stahl et al, in a prospective study of 9 years documented nosuperior aesthetic outcomes in comparison of 3-stage forehead flap technique, especially in relation to flap thickness compared with the 2stage technique. They considered 2-stage technique as better choice for nasal reconstruction, even in complex defects 17 .…”

Section: S173mentioning

confidence: 99%

Reconstruction of Nasal Ala Defects Using Three Staged Folded Forehead Flap: Aesthetic and Functional Outcomes

Ali

Tahir

Raza

et al. 2021

PAFMJ

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“…Several small comparative studies have attempted to objectively compare the aesthetic outcomes of 2- and 3-stage paramedian forehead flaps. 7 , 18 , 19 In 2012, Ribuffo et al utilized a visual analog scale (scored 1–10) to assess aesthetic and functional outcomes of 2- versus 3-stage flaps. Assessing flap thickness, the authors found that 3-stage flaps were significantly thinner at the nasal tip (1.62 versus 3.26 mm), dorsum (1.84 versus 3.63 mm), and sidewall (1.86 versus 3.6 mm).…”

Section: Introductionmentioning

confidence: 99%

“…The authors hypothesized that the additional surgical procedure may lead to increased risk of fibrosis at the nasal ala, which could contribute to differential thickness and satisfaction rates. 7 …”

Section: Introductionmentioning

confidence: 99%

“…Although objective metrics such as flap thickness were assessed, reported outcomes were largely subjective, making them difficult to quantify and compare across studies. 7 , 18 , 19 Additional large-scale investigations—preferably in a prospective manner, with validated patient questionnaires—are necessary to determine if there is a true differential in aesthetic outcome or patient satisfaction.…”

Section: Introductionmentioning

confidence: 99%

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Two or Three? Approaches to Staging of the Paramedian Forehead Flap for Nasal Reconstruction

Oleck

Hernández

Cason

et al. 2021

Plastic and Reconstructive Surgery - Global Open

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Summary The paramedian forehead flap is a historic cornerstone of plastic surgery and a mainstay of complex nasal reconstruction. Although initially described as a 2-stage procedure, several procedural advancements and modifications have been proposed, with the most notable being the addition of a third, intermediate stage. Proponents of this 3-stage approach argue that the addition of an intermediate stage improves flap perfusion, expands lining and structural support options, and provides superior aesthetic outcomes. Although this technique has grown in popularity, studies comparing the 2- versus 3-stage approach are relatively scarce in the literature. Existing comparative studies seem to suggest that the 3-stage paramedian forehead flap may have advantages in large, complex nasal defects and patients at high risk for vascular compromise. Additionally, comparative analyses with respect to aesthetic outcome were found to be largely equivocal, suggesting that surgeon comfort and preference should guide flap selection.

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Aesthetic rhinoplasty as the final step of nasal reconstruction with a forehead flap

et al. 2016

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Aesthetic and Functional Outcomes of 2-Stage Versus 3-Stage Paramedian Forehead Flap Techniques

Abstract: Therapy, Level III, and retrospective comparative study with prospectively collected data.

Cited by 12 publications

References 6 publications

Reconstruction of Nasal Ala Defects Using Three Staged Folded Forehead Flap: Aesthetic and Functional Outcomes

Reconstruction of Nasal Ala Defects Using Three Staged Folded Forehead Flap: Aesthetic and Functional Outcomes

Two or Three? Approaches to Staging of the Paramedian Forehead Flap for Nasal Reconstruction

Aesthetic rhinoplasty as the final step of nasal reconstruction with a forehead flap

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