Nasal reconstruction in the Yemen with the Converse scalping flap

Reconstruction of large nasal defects remains a surgical challenge. For a good result, there is a need to match the colour and texture of the nose, close or cover the donor site well and maintain good function. The use of forehead tissue for nasal reconstruction dates back to the Indian flap in 600BC,1 and modern techniques include the midline forehead flap, the paramedian forehead flap, the Gilles ‘up-and-down flap ’ and the McGregor transverse forehead flap.2–5 The main drawback of these is that the flap is short and under tension, so that perfusion may be compromised in the area where it is most needed, at the nasal tip. An alternative method, the scalping flap, was described by Jean Marquise Converse, of the New York University School of Medicine, in 1942.6 A pedicle of hair-bearing scalp is used to move forehead skin onto the nose for extensiv