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The Paramedian Forehead Flap for Nasal Reconstruction

From Antiquity to Present

Shokri, Tom, MD*; Kadakia, Sameep, MD; Saman, Masoud, MD; Habal, Mutaz B., MD, FICS§; Kohlert, Scott, MD, FRCSC; Sokoya, Mofiyinfolu, MD; Ducic, Yadranko, MD; Wood-Smith, Donald, MD

doi: 10.1097/SCS.0000000000004976
Original Articles

Nasal reconstruction is considered the historic foundation of facial plastic surgery, and the forehead flap remains the workhorse of repair. To recreate both the aesthetic contour and function of the nose, all anatomic layers must be addressed—covering, lining, and structural support. This article reviews the noteworthy history underlying the development of the paramedian forehead flap as the primary tool in reconstruction of large nasal defects while highlighting its implications on modern nasal repair. Current developments in the use of 2-staged paramedian forehead flap reconstruction are examined and a modern technique is presented.

*Division of Otolaryngology—Head and Neck Surgery, Penn State Hershey Medical Center, Hershey, PA

Otolaryngology and Facial Plastic Surgery Associates, Fort Worth

Saman Facial Plastics, Plano, TX

§Department of Communication Sciences and Disorders, University of South Florida, Tampa, FL

Columbia Presbyterian Medical Center, New York City, NY.

Address correspondence and reprint requests to Sameep Kadakia, MD, Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, TX; E-mail:

Received 19 July, 2018

Accepted 23 July, 2018

The authors report no conflicts of interest.

© 2019 by Mutaz B. Habal, MD.