Paramedian Forehead Flap

Spectacles under Pedicles: Eyewear Modification with the Paramedian Forehead Flap

“…When performed correctly, the paramedian forehead flap produces excellent cosmetic results with minimal donor site morbidity. Complication rates after surgery are low, 4 making this flap a mainstay of treatment in nasal reconstruction.…”

Paramedian Forehead Flap for Reconstruction of Nasal Tip Defect

“… 2 However, caution is advised in smokers, diabetics, and patients with atherosclerotic disease due to a higher risk of flap necrosis; surgical delay should be considered in these patients. 3 In addition, any anticoagulant medications should be noted preoperatively, though these medications can be safely continued with the exception of clopidogrel, which can lead to excessive bleeding. 2 Most importantly, patients must be counseled preoperatively and willing to undergo the 2 or more stages of this procedure, in between which they will require dressing changes to a conspicuous pedicle before division and final inset.…”

Interpolated Flaps

“…Indications for the paramedian forehead flap (PFF) include reconstruction of complex posttraumatic and postablative nasal deformities, deformities of the nasal-orbital ethmoid complex, medial canthus, and radius, and reconstruction of the exenterated orbit. 18 Young patients with little cheek laxity and inconspicuous melolabial folds should also be considered as candidates for the PFF. 19 Contraindications to the forehead flap include anatomic limitations, patient comorbidities, coagulopathies, and unrealistic patient expectations.…”

“…20 Its most unfortunate disadvantage lies in its conspicuous scar and the fact that it is multistaged. 18 Flaps larger than 4.5 cm are not amenable to primary closure and must be left to heal by secondary intention. 1 This often leaves significant scarring of the forehead.…”