Double Forehead Expanded Flaps for Reconstruction of Total Nasal Defect: A Case Report

ABSTRACT: Objective: To introduce a method for total nasal defect reconstruction with a double forehead expanded flap. Case presentation: A 55-year-old man underwent three-stage total nasal reconstruction for a complete nasal defect due to electrical injury. The skin expander was implanted during the 1st stage. Total nasal reconstruction was performed with double expanded forehead flap transfer during the 2nd stage. The unilateral forehead flap was used for lining and the contralateral forehead flap, together with the autologous cartilage and titanium mesh framework, were used for skin replacement. The forehead donor defect was covered with a skin graft. Pedicle division and inset were performed in the 3rd stage. Results: There was no flap loss, infection, hematoma, rhinostenosis, or implant exposure over the 2-year follow-up, and satisfactory aesthetic results were achieved. Conclusion: The double forehead expanded flap method is useful for the reconstruction of large composite nasal defects in patients who are not suitable for nasolabial flaps and those who may not tolerate free tissue transfer. The operation has fewer complications and is uncomplicated