Paramedian Forehead Flap for Nasal Reconstruction
Your Care at Home
A Paramedian forehead flap is a two stage surgery done to rebuild different defects of the nose.
Usually this is after a skin cancer has been removed.
During the first surgery your surgeon will take a skin flap from the forehead above your nose,
and move it down to cover the open area where the skin cancer was taken from your nose. Your
surgeon may also use some cartilage from your ear to help rebuild the shape of your nose.
What to expect after the first stage of surgery?
ξ You will have an incision and stitches on your forehead where the skin flap was taken
from and on your nose where the skin flap was sewn in place.
ξ The area where the skin flap was moved down will be raw and may ooze some blood.
This area will be covered with yellow gauze called Xeroform™.
ξ You may feel nervous about how you look after the first stage of the surgery; remember
that this is only temporary.
How to take care of your incision after Stage 1 surgery?
ξ Keep your incisions completely dry for 2 days following surgery. Then you may let
water run over the incisions and gently pat dry. Do not soak or scrub the incisions for 2
ξ You can gently apply a thin layer of antibiotic to the forehead incision area 2-3 times per
ξ The yellow gauze needs to stay in place at all times to keep the raw exposed area covered
and moist. The yellow gauze will be changed in a clinic appointment in 7-9 days.
ξ It will be hard to wear glasses after the first stage of surgery; they should not rest or put
pressure on the flap area.
The second surgery is done about 3-4 weeks after the first surgery. There needs to be a good
blood supply at the nose where the flap has been placed. This is a smaller surgery, but still
usually done under a short general anesthesia. At this stage the skin flap is separated. A small
part of the lower forehead is reopened and the inner eyebrow is recreated. The area where the
nose defect was can be shaped to look better.
How to take care of your incision after Stage 2 surgery?
ξ Keep your incisions completely dry for 2 days.
ξ After 2 days you can gently clean around your incisions with mild soap and water.
ξ You can gently apply a thin layer of antibiotic to the incision areas 2-3 times a day.
Activity after both stages of surgery
ξ Keep your head raised 30 degrees (use 2-3 pillows) to help keep swelling down the first
week after each surgery.
ξ Light activity only for 1 week after each surgery; no swimming, jogging, exercise classes
or contact sports.
ξ Avoid lifting more than 10 pounds for 1 week after each surgery.
ξ Plan to take a week off work; depending on the type of work you do this may need to be
ξ Do not use ice packs on your surgical site.
When to call your doctor or clinic nurse?
If you have any of the following symptoms, please call your doctor or clinic nurse:
ξ Any Sign of Infection
Increased pain, warmth or swelling at the surgery site
Cloudy pus like drainage from the surgery incision
Fever over 100.5 degrees on 2 readings 4 hours apart
ξ If the flap looks pale white, gray or black in color
ξ Bleeding that is soaking the dressings in 10 minutes or less
ξ If your pain is not controlled with pain medicine
Monday-Friday 8:00 a.m. - 5:00 p.m. call: ENT clinic (608) 263-6190
After 5:00 pm or weekends, the clinic number is answered by the paging operator. Ask for the
ENT doctor on-call. Leave your name, area code and phone number. The doctor will call you
If you live out of the area, please call 1-800-323-8942.
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 7/2015 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7795