Reconstruction of Hemi-Tip and Ala with Single Interpolated Paramedian Forehead Flap for Lining and Cover

Abstract

A 59-year-old man developed a basal cell carcinoma of the left nostril, which was resected and the defect reconstructed with an auricular cartilage structural graft and a right interpolated paramedian forehead flap. These procedures were performed by another surgeon and the details of the surgery were not available. The patient was referred to the author several years later with either a recurrence of his malignancy or a new basal cell carcinoma of the reconstructed left nostril. Examination of the nose demonstrated a well-healed paramedian forehead flap that had been transferred to the left nasal sidewall and nostril. The flap displayed hyperemia resulting in a poor color match with the adjacent nasal skin. There was an ulcerating basal cell carcinoma involving the reconstructed left nostril margin which extended cephaled into the sidewall and laterally toward the cheek. The patient reported no health problems but smoked one pack of cigarettes a day and had done so for 40 years.