The Paramedian Forehead Flap for Nasal Reconstruction: From Antiquity to Present

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. Address correspondence and reprint requests to Sameep Kadakia, MD, Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, TX; E-mail: sameep8779@gmail.com Received 19 July, 2018 Accepted 23 July, 2018 The authors report no conflicts of interest. © 2018 by Mutaz B. Habal, MD.

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