Abstract
At the International Symposium on Facial Plastic and Reconstructive Surgery held in June 1993, Kevin Shumrick, MD, presented a paper on total nasal reconstruction using the radial forearm macrovascular free flap and forehead flap. He and his co-author, Gary Burget, MD, discussed the use of the radial forearm flap for internal lining and the forehead flap for external nasal skin. The authors found the radial forearm flap most suitable for internal lining because of its thinness, pliability, excellent vascularity, and large surface area. The nasal supporting framework was reconstructed using a split calvarial bone graft rigidly fixed to the frontal bone with microplates and screws. The initial step in the reconstruction was transferring the radial forearm free flap and suturing it in place to the edges of the remaining nasal mucosa with the epithelial surface inward. The externally facing raw surface was covered with a split-thickness skin graft. In this
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