Modified Paramedian Forehead Flap for Nasal Tip Reconstruction.

Kang, Seok Joo; Kim, Nam Hoon; Kim, Jin Woo; Sun, Hook

doi:2012.13.2.143

Arch Craniofac Surg > Volume 13(2); 2012 > Article

Case Report

Archives of Craniofacial Surgery 2012;13(2):143-146.
DOI: https://doi.org/10.7181/acfs.2012.13.2.143

Modified Paramedian Forehead Flap for Nasal Tip Reconstruction.

Seok Joo Kang, Nam Hoon Kim, Jin Woo Kim, Hook Sun

Department of Plastic and Reconstructive Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea. sonydr@naver.com

Abstract

PURPOSE
The typical reconstructive option for the nasal tip is paramedian forehead flap. However, the forehead flap is too bulky for nasal tip reconstruction and does not look natural, and therefore, secondary operations for debulking are required. METHODS: We treated a 46-year-old woman who suffered from a nose tip soft tissue defect using a modified paramedian forehead flap. The flap was elevated from the hair line of the forehead and had 3-layered structure. The distal part included skin and subcutaneous tissue, the middle part included frontalis muscle, and the proximal part had periosteum.
RESULTS
The nasal tip was not bulky and looked natural in terms of height, shape, and had 3-dimensional structure without debulking procedure. The patient was satisfied with the outcome.
CONCLUSION
The authors' modified paramedian forehead flap may be a useful option for the treatment of nasal tip, columella, and alar defects. With these modifications, the paramedian forehead flap can provide an aesthetically acceptable nasal tip appearance without debulking.

Keywords: Nose; Skin defects; Reconstructive surgical procedures; Surgical flaps