Traditional lining techniques such as prefabricated flaps, hinge-over flaps, or second local flaps for lining are thick, stiff, or poorly vascularized. Support grafts have traditionally been placed incompletely or secondarily. Intranasal lining flaps have revolutionized reconstruction but are complex, tedious, and destructive to the residual nose. More recently, the forehead skin has been transferred for cover as a full thickness flap in three stages. It has allowed the modification of the traditional folded flap technique for lining to permit a simple, efficient, and widely useful method of lining replacement for common defects. Thin, supple, vascular lining is combined with delayed primary cartilage grafts to provide excellent functional and cosmetic results.
