Nasal Reconstruction Using the Menick Three-Stage Forehead Flap

Author(s)	Dr. Youssef Merimi, K.Benmoussa, H.Nejjar, A.Ouardi
Country	Morocco
Abstract	Nasal reconstruction after tissue loss remains one of the most difficult challenges in plastic surgery, and no single technique has consistently produced an ideal aesthetic outcome. We report the case of a patient with a full-thickness (transfixing) nasal defect treated with a three-stage forehead flap at the Department of Plastic, Aesthetic and Reconstructive Surgery, Oued Eddahab Military Hospital, Agadir, Morocco. The forehead is the preferred donor site for nasal resurfacing because its skin closely matches nasal skin in color and texture. However, a forehead flap is usually thicker than native nasal skin, regardless of its vascular pedicle. In the classical two-stage technique, the flap is transferred after limited distal excision of frontalis muscle and subcutaneous fat, and the pedicle is divided about three weeks later. This approach may leave the flap insufficiently thinned and carries a risk of necrosis, particularly in smokers and in extensive reconstructions. Menick therefore introduced an additional stage between flap transfer and pedicle division.
Keywords	nasal reconstruction, Menick technique, reconstructive surgery, transfixing nasal defect, nasal tumor
Field	Medical / Pharmacy
Published In	Volume 8, Issue 5, September-October 2026
Published On	2026-10-21
DOI	https://doi.org/10.36948/ijfmr.2026.v08i05.90159

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