Paramedian forehead flap for nasal tip reconstruction after Mohs surgery

  • Felipe Bochnia Cerci Hospital Santa Casa de Curitiba
Keywords: Mohs surgery, surgical flaps, nose neoplasms


The paramedian forehead flap is a great option for restoring complex nasal defects. Its main indications are large and deep wounds located on the distal third of the nose (tip and ala). For full-thickness defects, the paramedian forehead flap may be used alone or in combination with other methods. We presented a patient with a nodular basal cell carcinoma on the nasal tip and collumela treated by Mohs micrographic surgery and repaired with a paramedian forehead flap. Prior to reconstruction, it is essential that surgical margins are completely evaluated and free of tumor. For optimal paramedian forehead flap results, adequate surgical planning and meticulous technique are imperative.


Cerci FB, Nguyen TH. Paramedian forehead flap for com-plex nasal defects following Mohs micrographic surgery. Surg Cosmet Dermatol 2014; 6(1): 17–24.

Nguyen TH. Staged interpolation flaps. In: Roher TE, Cook JL, Nguyen TH, Mellete Jr, JR, (editors). Flaps and grafts in dermatologic surgery. New York: Elsevier; 2007. p. 91–105.

Jellinek NJ, Nguyen TH, Albertini JG. Paramedian fore-head flap: Advances, procedural nuances, and variations in technique. Dermatol Surg 2014; 40 (Suppl 9): S30–S42. doi: 10.1097/DSS.0000000000000112.

Burget GC, Menick FJ. The subunit principle in nasal reconstruction. Plast Reconstr Surg 1985; 76(2): 239–247. doi: 10.1097/00006534-198508000-00010.

Boyd CM, Baker SR, Fader DJ, Wang TS, Johnson TM. The forehead flap for nasal reconstruction. Arch Dermatol 2000; 136(11): 1365–1370. doi: 10.1001/archderm.136.11.1365.

Baker S. Internal lining. In: Baker S, Naficy S, (editors). Principles of nasal reconstruction. St. Louis: Mosby; 2002. p. 31–46.

Byrd DR, Otley CC, Nguyen TH. Alar batten cartilage grafting in nasal reconstruction: functional and cosmetic results. J Am Acad Dermatol 2000; 43(5 Pt 1): 833–836. doi: 10.1067/mjd.2000.107740.

Ratner D, Skouge JW. Surgical pearl: The use of free carti-lage grafts in nasal alar reconstruction. J Am Acad Derma-tol 1997; 36(4): 622–624. doi: 10.1016/S0190-9622(97)70253-6.

Cerci FB. Auricular cartilage graft for nasal reconstruction after Mohs micrographic surgery. Surg Cosmet Dermatol 2015; 7(2): 109–115. doi: 10.5935/scd1984-8773.201572649.

Newlove T, Cook J. Safety of staged interpolation flaps after Mohs micrographic surgery in an outpatient setting: a single-center experience. Dermatol Surg 2013; 39(11): 1671–1682. doi: 10.1111/dsu.12338.

Case Reports