Updates in forehead flap reconstruction of facial defects

The versatile and reliable paramedian forehead flap is the workhorse interpolated flap for nasal reconstruction and its use has been expanded to reconstruct other areas of the face. The goal of this article is to review the recent research describing the modern concepts and techniques in forehead flap reconstruction of facial defects. A variety of forehead flap concepts, techniques, and applications have been described in the recent literature in both nasal and facial reconstruction. Recent concepts include the phenomenon of vascular delay as well as more detailed study of the perfusion of the forehead flap at its various stages. Novel techniques include various approaches in staged reconstruction, adoption of the forehead flap for reconstruction of internal lining defects, and flap thinning. Although basic principles of the forehead flap have remained unchanged over the years, specific techniques and applications continue to be refined. The forehead flap continues to be a mainstay in the armamentarium of facial plastic and reconstructive surgeons.