Forehead flap in nasal reconstruction

We establish criteria for aesthetic forehead flap reconstructions and evaluate the effect of mathematical models and computer simulation of the operation in preoperative and peri-operative planning. We study a case series of 13 patients in an academic tertiary referral medical center. Most patients had nasal defects after Mohs ' surgery for tumor ablation. Patients were followed up for 2 years after reconstructive surgery. Three patients underwent midline forehead flap nasal reconstructions, and t0 patients underwent paramedian forehead flap nasal reconstructions. We used patient satisfaction and physician evaluation of aesthetic form and function restoration as the main outcome measures. There were no major compli-cations. Minor complications included short-term pincushioning in all patients, scar contrac-Lure that resolved after 8 months in one patient, and forehead necrosis after primary closure of the upper forehead in one patient. Computer simulation correlated two-dimension flap design to the transposition process. We conclude that the forehead flap is the optimal reconstructive modality for resurfacing large nasal defects. The paramedian forehead flap is superior to the midline forehead flap for nasal reconstruction, especially for distal tip recon-structions. Mathematical models and computer simulation of the reconstructive procedur