Skip Navigation LinksHome > April 2010 - Volume 125 - Issue 4 > Extended Forehead Skin Expansion and Single-Stage Nasal Subu...
Plastic & Reconstructive Surgery:
doi: 10.1097/PRS.0b013e3181d0acb1
Reconstructive: Head and Neck: Original Articles

Extended Forehead Skin Expansion and Single-Stage Nasal Subunit Plasty for Nasal Reconstruction

Weng, Rui M.D.; Li, Qingfeng M.D., Ph.D.; Gu, Bin M.D.; Liu, Kai M.D.; Shen, Guoxiong M.D.; Xie, Feng M.D.

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Abstract

Background: Forehead skin is often insufficient to use for nasal reconstruction because of a low hairline. In addition, skin graft used to repair donor-site defects results in obvious mismatched patches, whereas healing by secondary intention of donor-site defects causes conspicuous scars. To make up for the shortage of forehead skin used for nasal reconstruction and primary donor-site defect closure, the authors challenged the conventional idea of late shrinkage of expanded forehead flaps for nasal construction, and suggest a technique combining extended forehead skin expansion with single-stage nasal subunit plasty.

Methods: This technique was applied to 43 patients for nasal reconstruction over a 9-year period. The technique consists of three stages: extended forehead skin expansion, single-stage nasal contouring and subunit plasty, and pedicle restoration. All cases were followed for at least 12 months. Outcomes were evaluated in terms of aesthetics, function, and donor-site aesthetics.

Results: No secondary shrinkage occurred in any of the cases. Eighty-one percent of the patients assessed themselves as satisfactory for aesthetics, 70 percent assessed themselves as satisfactory for function, and 77 percent assessed themselves as satisfactory for donor-site aesthetics. The complications included minor brow elevation (five cases), L-strut distortion (four cases), stuffiness of the nostrils (four cases), flap hyperpigmentation (one case), flap skin paleness (one case), and alar graft extrusion (one case).

Conclusion: The combination of extended forehead skin expansion with single-stage nasal subunit plasty overcomes the defect of late shrinkage of an expanded flap for nasal reconstruction and achieved satisfactory results in aesthetics (nose and donor site) and function.

©2010American Society of Plastic Surgeons

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