The forehead flap: minimising the secondary defect by preservation of the frontalis muscle

The most frequent objection to the use of the forehead flap for intraoral reconstruction is that it leaves an unsightly secondary defect, an adherent shiny skin graft and an expressionless forehead. However, it is possible to raise the flap superficial to the frontalis muscle leaving its structure and innervation intact. Expressive movement is preserved and the secondary defect minimised. The technique is described and illustrative cases are presented.