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Esthetic Nasal Reconstruction Using Forehead Flap.

Adira Kruayatidee¹, Pasha Shakoori², J Andres Hernandez³

¹Roxbury Clinic and Surgery Center, Beverly Hills, CA.

The Journal of Craniofacial Surgery

|May 25, 2026

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This study introduces a 3D algorithmic approach for paramedian forehead flap reconstruction in major nasal defects. The method ensures optimal form and function, achieving 100% patient satisfaction for nasal reconstruction.

Area of Science:

Plastic Surgery
Reconstructive Surgery
Nasal Reconstruction

Background:

The paramedian forehead flap is crucial for extensive nasal defects.
Existing guidelines lack a comprehensive 3D framework for individualized planning.

Purpose of the Study:

Present a 3D algorithmic approach for nasal reconstruction using forehead flaps.
Evaluate aesthetic and functional outcomes of multilayered reconstructions.

Main Methods:

Detailed a 3D reconstruction algorithm covering skin, soft tissue, bone, cartilage, and lining.
Presented four cases with diverse etiologies undergoing forehead flap reconstruction.

Main Results:

Achieved restoration of nasal form and function.

Keywords:

Autologous forehead flap nasal reconstruction rhinoplasty

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Reported 100% patient satisfaction.

Demonstrated no loss of reconstruction over an average 19.5-month follow-up.

Conclusions:

Successful nasal reconstruction requires a comprehensive top-down, outside-in approach.
Patient-specific graft selection and timing of flap division are key for optimal outcomes.
The described algorithm facilitates excellent functional and aesthetic results in complex nasal reconstructions.