As the name suggests, a forehead flap is taken from the forehead. Broadly speaking a cut is made, starting from the inner aspect of the eyebrow near to the nose. The cut is extended up to the hairline, then curves round to come back down to the eyebrow, about 2cm away from the first cut. The skin is then lifted with the underlying fat and some muscle, but kept attached at the eyebrow. This is called the flap, and it is now turned round to reach the wound on the nose.
The flap is stitched in place on the nose, and the forehead wound is closed. Sometimes the upper part of the forehead wound is too tight to close, and this is usually left to heal over the next few weeks.
The forehead flap is kept attached to the eyebrow, as this is how the blood flows in and out of the flap. Over the next 3-4 weeks the flap ‘learns to live’ from the nose, and new blood vessels from the nose grow into the flap skin. At this point, the forehead flap can be divided from the eyebrow as the skin can now survive on the nose.
Sometimes, a cartilage graft is also used under the forehead flap, to help give the nose more strength and shape.