Reuse of the paramedian forehead flap pedicle: A case report

Abstract

The paramedian forehead flap is an axial flap which utilizes vascular support from the supratrochlear artery to repair extensive nasal defects. Adverse outcomes including flap necrosis, infection, alar rim pull, and poor cosmesis can be seen with this flap. We report an 85-year-old woman with chronic obstructive pulmonary disease who underwent a staged paramedian forehead flap repair with a cartilage inlay complicated by moderate left alar rim necrosis and pedicle notching. In this patient, we were able to salvage the original pedicle and reposition it to achieve a satisfactory functional and cosmetic outcome.

Danger Zone for Paramedian Forehead Flap Elevation: Maximizing Flap Length and Viability

“…Paramedian forehead flaps provide several other advantages, including providing ample tissue to cover large defects, and can be used to correct congenital [20] or acquired lesions [9,21,22]. Additionally, the paramedian forehead flap can be reused to repair remnant defects [23,24], as well as having the inherent flexibility to be modified by reconstructive surgeons to best suit individualized, patient-specific midfacial features [8,22,25]. Most importantly, these flaps, when dissected and implemented correctly, are associated with positive long-term outcomes [9].…”