Facial plast Surg 1998; 14(2): 159-164
DOI: 10.1055/s-2008-1064340
© 1998 by Thieme Medical Publishers, Inc.

Subtotal Nasal Reconstruction Using a Bi Valved Paramedian Forehead Flap

Jonathan M. Sykes1 , Christopher J. Tolan2
  • 1Associate Professor, Facial Plastic Surgery, Department of Otolaryngology/HNS, Davis Medical Center, University of California, Sacramento, California
  • 2Fellow, Facial Plastic and Reconstructive Surgery
Further Information

Publication History

Publication Date:
02 June 2008 (online)


Many surgical options have been proposed for total or subtotal reconstruction of the nose after extirpative surgery or trauma. Careful replacement of all anatomic layers including the structural framework and internal and external nasal lining is essential to successful reconstruction. If adequate internal lining is present, reconstruction of the structure of the nose and the external nasal lining is often straightforward. Difficulty arises with providing sujfficient internal nasal lining in patients who underwent full thickness reconstruction of half of the nose with a bi-valved paramedian forehead flap. A different plane of dissection is used for the flap and structural grafts are placed between the layers of the axial pattern flap. The anatomy, plane of flap dissection, and biomechanics of flap transfer are presented as well as the specific technique for nasal reconstruction. The bi-valved paramedian forehead flap presents another surgical option for reconstruction of full thickness defects of the nose.