ePlasty: Vol. 17
Reconstruction of a Nasal Defect With a Radial Forearm Flap Following Trauma of a Paramedian Forehead Flap
Benson J. Pulikkottil, MD, Ronnie A. Pezeshk, MD, James F. Thornton, MD, FACS and Nicholas T. Haddock, MD, FACS

Department of Plastic and Reconstructive Surgery, University of Texas Southwestern Medical Center, Dallas


Correspondence: nicholas.haddock@utsouthwestern.edu
Keywords: paramedian forehead flap, radial forearm arm free flap, microsurgery, nasal reconstruction, Mohs surgery

DESCRIPTION

A 49-year-old woman presented with a 3-cm nasal wound after Mohs surgery for basal cell carcinoma of the right ala (Fig 1). She underwent reconstruction with a cervicofacial advancement flap closure, left paramedian forehead flap with turn in for lining, and left mucosal soft tissue advancement, as well as a right ear conchal cartilage graft for the right ala. On postoperative day 7, she presented after the flap was unintentionally divided by the home care nursing staff during a dressing change (Fig 2). The reconstructed portion was nonviable. She successfully underwent a radial forearm free flap reconstruction to repair this defect (Figs 3 and 4).

Figure 1. 3-cm nasal wound after Mohs surgery for basal cell carcinoma of the right ala.