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The median forehead flap is the mainstay for repairing nasal defects larger than 2 cm. Rather than use a traditional flap that straddles the entire glabellar region, most surgeons use a paramedian forehead flap variation based on the supratrochlear vessels. These authors discuss their experience with a modified paramedian forehead flap employed in 94 patients with large nasal defects related to skin cancer.
The mean time from flap placement to division and inset was 27 days. Half the patients required at least one defatting procedure to thin the flap. Sixteen patients had conchal cartilage grafts to replace missing cartilage. Twenty-one patients needed lining repair; the flap was turned over on itself to replace missing mucosa in 12, and 9 r…