Nasal reconstruction with the paramedian forehead flap using the aesthetic subunits principle.
Reconstruction of nasal defects is challenging because it requires covering skin, supporting framework, and lining. Traditionally, the forehead flaps are transferred in 2 stages; however, it can be accomplished in a single stage or in 3 stages. Few published studies are available about the paramedian forehead flap using the intermediate stage (3-stage) and the aesthetic subunits principle. The purpose of this study is to evaluate the use of the paramedian forehead flap in 2 and 3 stages for nasal reconstructions, highlighting the indications, complications, and technical details and evaluating the patient's satisfaction through a questionnaire about the quality of life (Derriford Appearance Scale 24). A retrospective review was performed between 2011 and 2013 for a consecutive series of 11 patients who underwent nasal reconstructions using the paramedian forehead flap in 2 or 3 stages. All preoperative and postoperative data were collected, and outcomes were also assessed through a questionnaire about the patients' postoperative quality of life. The causes of nasal lesions varied among skin cancer, trauma, and infection. Two-stage paramedian forehead flap reconstruction was performed upon 4 patients, whereas the 3-stage reconstruction was performed for 7 patients. Of the 10 survey respondents, 6 were highly satisfied (score of 11-27), and 4 were moderately satisfied (score of 28-44), whereas no one was dissatisfied after his/her surgical nasal reconstruction procedure. Whether the approach is accomplished in 2 or 3 stages, all areas of the reconstructed nose must be firmly supported. Applying the nasal subunits principle seems to contribute to an overall satisfied population in our study, according to the score obtained by the questionnaire about quality of life.
From the *Plastic and Reconstructive Surgery Division, Federal University of Bahia-Salvador/Bahia; †Plastic and Reconstructive Surgery Division, University of São Paulo-São Paulo/São Paulo; and ‡Federal University of Bahia-Salvador/Bahi, Brazil.
Victor Diniz
VD
de Pochat
Nivaldo
N
Alonso
Emilie Barreto
EB
Ribeiro
Bruno Suffredini
BS
Figueiredo
Eduarda Nilo
EN
de Magaldi
Marcelo Sacramento
MS
Cunha
José Valber Lima
JV
Meneses
D000328:Adult; D000368:Aged; D004954:Esthetics; D005260:Female; D005546:Forehead; D006801:Humans; D008297:Male; D008875:Middle Aged; D009667:Nose Deformities, Acquired / Q000601:surgery*; D017060:Patient Satisfaction; D011788:Quality of Life; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000379:methods*; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps; D011795:Surveys and Questionnaires