Introduction: Reconstruction of the nose has the dual aim of preserving function and restoring aesthetics. The forehead flap is a useful tool in the repair of larger and more complex nasal defects.

Methods: Retrospective study of consecutive patients who underwent nasal reconstruction using forehead flap during the period August 2002–April 2011.

Results: Fifty patients with median age of 67 years had forehead flap reconstruction. The majority of the defects resulted from excision of skin cancer. 73% of these patients had conventional excision and 27% Mohs surgery. The average size of the defect was 26 mm. The defects involved multiple aesthetic subunits.

Cartilage grafting was used in 12% of cases. Third stage refinement procedure was performed in 4 patients. Two patients developed post operative wound infection which settled with oral antibiotics. Two cases experienced necrosis of the distal part of the flap.

Conclusion: The paramedian forehead flap is a reliable technique in nasal reconstruction. Surgical morbidity is low and aesthetic outcome is very satisfactory.

Conflict of interest : None declared.