Three-stage folded forehead flap for nasal reconstruction: objective and subjective measurements of aesthetic and functional outcomes.

Publication date: Available online 17 October 2017
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Warren Noel, Jean-Brice Duron, Samer Jabbour, Marc Revol, Sarra Mazouz-Dorval
BackgroundThis three-stage folded forehead flap (FFF) proved to be a simple and readily available method of lining replacement. To date, no clinical trial has evaluated the outcomes of the FFF the nose shape and function.MethodsPatients undertaking a full thickness unilateral alar reconstruction with a forehead flap between January of 2010 and December of 2015 were included for analysis. Patients were divided into two groups: The FFF group included patients that had a unilateral alar reconstruction using a three-stage folded forehead flap; the standard forehead flap (SFF) group included patients that had a reconstruction using a two-stage forehead flap in combination with another method for lining reconstruction. The following objective measurements were done: The alar thickness, the nostril and hemi-nose areas and the nostril height. Subjective evaluation of the results was assessed using the NAFEQ score. Independent raters also evaluated the appearance of the nose.Results31 patients were included: 15 in FFF group and 16 in the SFF group. In both groups, the reconstructed ala was thicker than the normal side, the reconstructed nostril was smaller than the normal nostril and the reconstructed hemi-nose was bigger than the normal side. 84% of patients were satisfied with their total nasal functioning. All the patients were satisfied with their total nasal appearance.ConclusionThe FFF showed objective, subjective, aesthetic and functional results comparable to other lining reconstruction techniques.