title: Simplifying the Forehead Flap for Nasal Reconstruction: A Review of 420 Consecutive Cases.
abstract: BACKGROUND
  The forehead flap is an important tool in nasal reconstruction. The authors present objective data and recommendations based on over a decade of consecutive forehead flap nasal reconstructions performed by the senior author (J.F.T.). In addition, the authors separate the technique into its individual steps and provide details of the senior author's approach to each.
  
  
  METHODS
  The authors performed a retrospective analysis of patients who underwent nasal reconstruction with the forehead flap over a 10-year period performed by the senior author (J.F.T.). Each case was evaluated for defect location, pedicle design, time of division, number of stages, use of cartilage grafts, lining reconstruction, donor-site closure, and complications.
  
  
  RESULTS
  Four hundred twenty patients underwent forehead flap nasal reconstruction. Average time to pedicle division was 32 days. Three-fourths of patients completed reconstruction in two stages. Defects most commonly involved the nasal ala and tip. Approximately half of patients received cartilage grafts and half underwent lining reconstruction. There were 16 complications, ranging from partial flap loss to postoperative death (n = 1).
  
  
  CONCLUSIONS
  Confidently grasping the nuances of forehead flap nasal reconstruction arms the reconstructive surgeon with a reliable tool that can effectively treat a variety of defects. It is safe to use in an outpatient setting even in elderly patients. Recommendations include ipsilateral flap design and turn-in component as the first choice for lining replacement.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Dallas, Texas.|From the Department of Plastic Surgery, University of Texas Southwestern Medical Center.
authors.forename: Kyle
authors.initials: K
authors.lastname: Sanniec
authors.affiliation: Dallas, Texas.|From the Department of Plastic Surgery, University of Texas Southwestern Medical Center.
authors.forename: Menyoli
authors.initials: M
authors.lastname: Malafa
authors.affiliation: Dallas, Texas.|From the Department of Plastic Surgery, University of Texas Southwestern Medical Center.
authors.forename: James F
authors.initials: JF
authors.lastname: Thornton
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005546:Forehead / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000379:methods*; D013524:Surgical Flaps