PREOPERATIVE DIAGNOSIS: Status post 1st-stage midline forehead flap reconstruction of nasal defect.
POSTOPERATIVE DIAGNOSIS: Status post 1st-stage midline forehead flap reconstruction of nasal defect.
PROCEDURE: Take down of tubed midline forehead flap.
PROCEDURE IN DETAIL: The patient was taken to the operating room, and general anesthesia with orotracheal intubation was performed. The face was prepped with Betadine, and local injection with 3 mL of 0.5% lidocaine plus 1:200,000 of epinephrine was performed. The pedicle was then taken down, and the stump was ellipsed out. The medial brow was rotated back into position, contoured, and sewn into place with nylon. The dorsal flap was then slightly undermined, debulked, contoured, and inset. Subcutaneous fat was thinned. This was closed with nylon. The forehead donor site was then debrided, and 2 nylon sutures were removed. There was a small defect with some granulation tissue around it in the hairline, and this was debrided and thoroughly cleaned.
The patient was then awakened, extubated, and transported to the recovery room in stable condition.