Abstract
Background Current literature describes the forehead as one aesthetic subunit of the face. We
argue for the usefulness of aesthetic forehead subunits when microvascular flap reconstruction
is required. Key to utilization of microvascular flaps for restoration of forehead
subunits is an understanding of the patient population and defect characteristics
most amiable to treatment.
Methods We conducted an International Review Board–approved retrospective chart review of
nine consecutive patients who had undergone free flap reconstruction for large forehead
defects.
Results The patients' foreheads included one paramedian defect; one central and paramedian
defect; four central, paramedian, and lateral defects; and three lateral defects.
Seven patients had ulnar forearm flaps and two had anterolateral thigh flaps. The
success rate was 100%.
Conclusion A forehead subunit classification system has been devised that provides a suitable
option for cases that benefit from distant tissue replacement in a single stage, while
preserving the principles of aesthetic replacement.
Keywords
forehead aesthetic subunit - forehead microvascular flap - paramedian - central -
lateral forehead subunits
