One-stage nose reconstruction using a forehead island flap

Only part of the nasal skeleton remains after resection of extensive tumours penetrating all layers of the nose. In most cases a multiple-stage procedure is necessary for reconstruction of subtotal and total nasal defects. However, a one-stage reconstruction is needed in old and physically disabled patients who cannot undergo multiple operations for medical or social reasons. Three cases of nasal reconstruction with an inverted forehead island flap are reported. The skin of the inferiorly transposed flap serves as an inner lining for the reconstructed nose; the outer layer of the flap, which forms the surface of the reconstructed nose, is covered by a split thickness skin graft. The advantages of the method are: (1) one-stage reconstruction of the nose after tumour resection without further operations; and (2) the relative stability of the reconstructed nose without cartilaginous or bony implants.