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Nasal Reconstruction Forehead
Flap in a Patient
With
Morfeaform Basal Cell Carcinoma ( Skin Cancer )
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1.
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2 |
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A
patient
with a large morpheaform basal cell carcinoma of the nose was removed with Mohs
surgery.
Morpheaform basal cell carcinoma tracks
under the skin and large defects are often required to remove seemingly
small lesions. |
The patient also had a large morpheaform basal
cell carcinoma of the right upper lip. |
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| A very large defect
was created on the nose and lip. |
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4. |
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| The lateral view
of the lip and nose defect. |
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The appearance of the defect before surgery.
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The appearance of the defect before surgery. |
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7. |
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8. |
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The lip defect
was approximately 25%. It was treated by performing a "V" resection
and primary closure. |
A forehead flap
was outlined. The patient had tight skin and a flap width of two
centimeters was used. Unfortunately, the required length meant using
hair bearing skin. |
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9. |
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The forehead flap is elevated and placed horizontally in position. The
nasal defect was narrowed in height by undermining and advancing the skin on
the superior aspect of the nose. |
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10. |
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11. |
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| Final Closure of
First Stage. It is very important to close the
facial layer of the scalp to take the pressure off of the skin. |
Final Closure of First Stage. |
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12. |
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13. |
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| An Adaptic Dressing
is applied over the pedicle. Antibiotic ointment is used to coat the
remaining dress wounds. |
Day 1 Post-Op First Stage. |
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| Since the patient has
relatively dark hair and fair skin, laser therapy can be used to remove the
hair on the flap. In patients with light hair or a darker completion,
this may not be an option. |
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14. |
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15. |
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| Day 9 Post-Op First
Stage. |
Day 15 Post-Op First Stage. The redness was due to an allergy to the
antibiotic ointment used. |
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16. |
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Day 22 Post-Op First Stage. |
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18. |
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| Day 29 Pre-Op
Second Surgical Stage. |
Second Stage, Immediate Post-Op Result. |
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20. |
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Second Stage, 1 week result. |
Second Stage, 1 week result. |
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22. |
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Second Stage, 1 week result. |
Second Stage, 1 week result. |
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21. |
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22. |
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Second Stage, 6 week result. |
                             
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