Today, I reconstructed not one but ✌🏼 nasal defects due to skin cancer using a paramedian forehead flap with cartilage grafting- rib cartilage in one case and ear cartilage in the other!
Believe it or not, use of the forehead for nasal reconstruction dates back to ancient India (600-700 BC), when nasal tip amputation was a common punishment for a variety of crimes. 😬
The forehead flap is still considered the gold standard for 👃🏼 nasal reconstruction, particularly for defects involving a lot of skin and/or extending deep to include part of the structure or inside lining. The color and texture of forehead skin actually matches the skin of the nose quite nicely.
The only downside is that at least two surgeries are required for a forehead flap. After the first surgery, the forehead is left connected 🔛 the nose for about 3 weeks to allow it to heal and develop new blood supply.
Fun fact: Patients who undergo this surgery will initially “feel it” in their forehead when they scratch their new nose!
Happy Monday! 🤓 ...