Reconstruction of nose defects using external temporoparietal fascia prefabricated forehead flap - an innovative surgical approach.

Nasal reconstruction remains one of the most complex challenges in reconstructive plastic surgery due to its intricate three-dimensional architecture and functional demands. While the forehead flap has emerged as the gold standard for nasal reconstruction, conventional techniques inevitably produce conspicuous longitudinal forehead scarring at the pedicle site. We present an innovative approach combining external temporoparietal fascia prefabrication (E-TPFF) with tissue expansion technology to address these limitations. This article aims to enhance the existing method to meet the demand for nasal defect repair while eliminating the operation's drawbacks. Our modified technique offers three significant advantages: (i) complete elimination of visible forehead scarring through an external temporoparietal fascia prefabricated forehead flap (E-TPFF); (ii) providing a flap with reliable vascular supply through temporoparietal fascia prefabrication, and (iii) generation of sufficient flap volume and pedicle length to accommodate even extensive maxillofacial defects. Preliminary results demonstrate that the E-TPFF technique maintains all benefits of traditional forehead flaps while overcoming their most notable aesthetic drawbacks, representing a substantial advancement in facial reconstructive surgery.