Total nasal reconstruction: Utility of the free radial forearm fascial flap

Catherine P. Winslow, Ted A. Cook, Alan Burke, Mark K. Wax

Research output: Contribution to journalArticlepeer-review

45 Scopus citations


Background: Total nasal defects present daunting challenges to the reconstructive surgeon. The nasal skeleton can be successfully fabricated with bone and cartilage. Reconstruction of the nasal skin with a forehead flap produces an excellent color match for nasal skin. Resurfacing of the internal lining is the most difficult of the 3 layers. Local tissue is often unsatisfactory in amount and/or vascular supply. Methods: A patient requiring total nasal reconstruction was prospectively examined. Intraoperative technique was recorded, and postoperative function was determined. Results: A paramedian forehead flap was used to resurface the external defect. Split calvarium and conchal cartilage were used to reconstruct the nasal skeleton. A fascial flap harvested from the forearm was used to replace the intranasal lining. Turbinate grafts were placed to line the flap. Postoperative breathing was excellent. Conclusions: The intranasal portion of a total nasal defect can be successfully reconstructed with a fascial forearm flap. Placement of a turbinate or mucosal graft allows for a thin mucosalized lining with an excellent functional outcome.

Original languageEnglish (US)
Pages (from-to)159-163
Number of pages5
JournalArchives of Facial Plastic Surgery
Issue number2
StatePublished - 2003

ASJC Scopus subject areas

  • Surgery


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