This approach is performed AFTER radiation therapy is complete.
Wait at least 6 months to assess for early recurrence.
Wait at least 6 months after radiation before attempting reconstruction to optimize wound healing.
This technique should only be attempted by surgeons with experience in radial forearm free flap reconstruction and open Rhinoplasty, as it has a relatively high difficulty level.
This 5-stage technique works ONLY if you have a forehead flap that can be used, as it is used for external nasal skin reconstruction.
If a forehead flap is not available due to cranial vault hardware or other injuries to the vessel, consider using radial FF skin for external nasal skin reconstruction instead.
A future video lecture will demonstrate this type of reconstruction.
5-Stages:
Osteocutaneous radial FF (for vestibular lining), Radius Bone creates dorsal L strut, Rib cartilage provides the rest of the framework (including Caudal L-strut), Forehead flap for external nasal skin
