The expanded forehead scalping flap: a new method of total nasal reconstruction

The challenge of total nasal reconstruction is particularly formidable in the pediatric patient. Forehead skin is taut, and conventional methods of reconstruction, such as the midline forehead flap, provide a paucity of tissue in this age group. Tissue expansion is well-suited modification to overcome this limitation, but as applied to the midline forehead flap, it does not address the resulting vertical forehead scar. We present a new technique for total nasal reconstruction using an expanded, transversely oriented forehead scalping flap in a pediatric patient. This approach not only provides a generous amount of forehead skin but also limits donor-site morbidity and scarring by orienting incisions transversely at the hairline and within the scalp.