Augmentation rhinoplasty by subcutaneous midline forehead flap simultaneous with implant removal

Implant exposure after augmentation rhinoplasty with alloplastic materials is usually associated with some degree of infection, and it is commonplace to remove the implant and wait for several months before re-augmentation. However, some patients cannot accept the resultant deformity after implant removal. We introduced the midline forehead flap for augmentation simultaneous to the removal and obtained favorable results, even when considering the donor site scar on the forehead. We report the surgical technique and two patients treated with this procedure. The advantages and disadvantages of this procedure are also discussed.