The forehead flap nose reconstruction technique is performed when nasal wounds cannot easily be repaired using alternative methods. As such, flap reconstruction is typically the preferred option in cases where the nasal wound measures more than 15 millimeters across. Since wounds of this size generally occur following the surgical removal of malignant skin tumors, it’s relatively common for flap reconstruction to be performed following Mohs surgery. Visit this site at https://www.rhinoplastysydneycost.com.au/revision-rhinoplasty-sydney/ for more information.
Prior to Surgery
Standard presurgical safeguards are implemented prior to the reconstructive procedure. As is the norm, patients are required to inform their surgeon of any medicines they may be taking and of any allergies they may have. Moreover, if patients are taking antiplatelet medicines or anticoagulant medicines, they may have to temporarily discontinue doing so.
Patients will be assessed by an anesthetist to determine their suitability for surgery. Furthermore, prior to undergoing procedures which use general anesthesia, patients are required to fast.
The Surgery
In broad strokes, the reconstructive process essentially involves using a flap of forehead skin which has its own blood supply to cover a nasal wound. This flap remains in place until the nasal wound has fully healed. At which point, the flap is disconnected from the forehead. Overall, the surgical procedure is divided into 2-3 constituent stages.
Stage 1
As stands to reason, the first stage of the reconstructive procedure entails creating the flap which will cover the nasal wound. Generally, this stage of surgery is conducted under general anesthesia and, depending on the complexity of the procedure, lasts 1-4 hours.
First off, a template of the nasal wound is created. This newly-created template is then positioned so that it extends from just beneath a patient’s hairline as far as their inner eyebrow. Once the template is in place, the operating surgeon will then cut around it to create the flap. Next, the flap is turned upside down and attached to the wound site using either surgical glue or minute stitches.
The forehead wound is also stitched back together. However, from time to time, an area may be left open. This scenario typically arises in cases of large nasal wounds. When surgeons are unable to stitch the wound completely, the exposed area which results is covered using dressings. Occasionally, cartilage is transplanted from the ear or from inside the nose to support the shape of the nose.
Stage 2
The second stage, which entails thinning the flap to restore a natural nasal appearance, is in many ways a discretionary procedure. Indeed, this operation is only performed in cases where the forehead skin proves to be bulkier than the surrounding nasal skin.
To rectify the issue, the surgeon starts by cutting out the flap. Next, excess tissue is removed from underneath the flap. Once that is done, the flap is stitched back into place.
Stage 3
The third stage of the procedure takes place once the flap has fully healed. Basically, the operation entails surgically disconnecting the section of flap skin which links the forehead to the nose. Thereafter, as soon as any necessary stitches have been placed, dressings are applied to expedite the healing process.
Risks
Overall, forehead flap nose reconstruction is considered to be a safe procedure. However, as with any type of surgery, there are some risks. These risks include;
- Scarring
- Flap failure
- Numbness
- Bleeding
- Pain
- Abnormal hair growth on the nose
- Blood Clots