Debating Forehead flap: how long until the flap comes down?

Hello!  Thank you for the question. Both flaps are excellent options for nasal reconstruction.  Choice sometimes depends on size and location of the defect. Any surgical procedure will certainly leave a scar at the donor site, but should be hidden within an existent natural fold or wrinkle.  These flaps often result in a superior aesthetic result than closure or skin grafts.  Typically, the forehead flap is rotated to the defect, then ultimately divided and reinset at 3 weeks.  Hope that this helps!  Best wishes!

This depends upon the size and the location of the defect. The forehead flap can repair larger defects and those that are involving the tip. Unfortunately, the scar on the forehead is always visible and very unnatural looking. The flap can be taken down in as little as one week or as long as three, depending upon the surgeons preference. After takedown, it can appear fairly full for several weeks or longer. Injections of corticosteroids can help reduce the fullness. Sometimes, additional surgery is needed to correct this or dermabrasion. All in all, the result is very good.A cheek pedicle flap can be used and works best for smaller defects involving the lateral nose or ala. In some cases, the pedicle can be tunneled under the skin so that there is no visible surgery and no need for a second procedure. The scar on the cheek can be concealed fairly easily, unlike the forehead flap, and results are usually very good. 

Thank you for your question! This is quite a common concern, as these two flaps are very regularly used in nasal reconstruction. Although the flaps may sound quite drastic, they really do give excellent results and in most cases, superior results to skin grafts or other local tissue for larger wounds.One point that may help you decide is what your anatomy may tell us about which flap may suite you best. If you have heavy smile lines already, or deep folds, the scar may hide quite well once it heals. If you do not have any significant fold or line in this region, a forehead flap may be the best option. As my colleagues have said below, all reconstructive options will leave a scar, but with careful technique and good postoperative care (and no smoking!) the results can be quite good. At 2-3 weeks after your reconstruction, the flap will be divided. If the flap needs additional thinning, it may be able to be done prior to your return to school, or could be done at a later date to improve the final result. Dermabrasion or laser resurfacing can also be done to improve the scars themselves and help "airbrush" the final results. Best of luck to you!! 

Forehead flaps typically stay attached for 3 weeks. With regard to scarring, neither interpolated cheek or forehead flaps heal without a scar. The cheek flap scar is hidden in the smile line while the forehead flap creates a vertical scar above the inner portion of the brow. Both tend to heal nicely but the choice of the best flap depends upon the size and location of the nasal defect as opposed to the location of the scar. By 8 weeks after the initial reconstruction you should be far along in healing but there will still be redness, swelling and evidence that you've had recent surgery. I wish you the best of luck! A skilled reconstructive surgeon can really create very nice results. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon