Typically in the first stage a strip of skin from the forehead is brought down to the nose. Often parts of the tip of the nose must be reconstructed by using cartilage taken from behind the ear. This does not significantly change the shape of the ear. This strip of forehead skin must then stay attached for 3 weeks (click for image). This is the length of time necessary to establish a proper blood supply for the new skin in this area. Admittedly, this can be a difficult time of being out in public for many patients.

The second stage of the operation is where we put everything back together. The connection between the forehead and the nose is divided. The skin is contoured to look like nasal skin and both the nose and forehead are stitched carefully back together.

Less commonly a third stage is needed. This is most often the case when a significant amount of the nose has been lost to cancer or if the reconstructed area needs further refinement to achieve optimal nasal contouring. If you need a 3rd stage this will be discussed in detail in your consultation.

Forehead flaps are usually performed on an outpatient basis. Some patients are kept overnight in the hospital after the first stage. While patients can look a bit “ghoulish” for the 3 weeks following the first operation, they can go back to normal activity levels rather quickly. In my patients one of the main limitations I have seen is that it can be difficult to wear eyeglasses for the 3 weeks following the first stage. Obviously, most patients choose to avoid major social engagements for the 3 weeks following the first stage.

Recovery from the second stage is much quicker. Patients can go back to light activities a few days after surgery and can usually easily be back at work within a week after the second stage.

Dr. Mobley wants to make cosmetic surgery available to as many people as possible. For that reason we have hand picked lending services exclusively for Dr. Mobley's patients. When you come in for your consultation we will be more than happy to go over all your financial options with you. We have provided web links to our financial lenders so that you may research them on your own if you so desire.www.mlendfinancial.com

When reconstructing the human nose, symmetry is critical. Based on the reconstructive challenges your case presents, as well as your desires, some patients opt for an additional stage so a minor touch-up can be performed. This may involve thinning down skin that looks a bit thick, correcting nostril asymmetry, or other small detail work to make your nose look as normal as possible. These touch-up procedures are not a risk of surgery; rather, they are a possible, optional operation to get the reconstructed nose to look as much like your original nose as possible.

Everyone knows that experience is one of the most important traits a surgeon can have. Dr. Mobley has extensive experience in forehead flap surgery. He is the only University of Utah Facial Plastic Surgeon and as such sees a significant number of forehead flap patients every month. Dr. Mobley also trained under the world-renowned forehead flap surgeon, Dr. Gary Burget, MD, during his prior training in Facial Plastic Surgery fellowship. His practice welcomes patients who wish to go out of network to benefit from Dr. Mobley’s experience.

Dr. Mobley performs the majority of complex facial skin cancer reconstructions at the University of Utah. In the past year, he performed 71 skin cancer reconstructive surgeries. Most of these were moderate or major cases, many of them requiring multiple stages to complete. Dr. Mobley frequently uses forehead flaps to reconstruct major nasal defects. Forehead flaps are used when the size and depth of the defect requires replacement of all three layers of nasal tissue. Dr. Mobley is experienced at educating patients about the staged reconstructive process and has developed innovative techniques to maximize his results, and he has been invited to teach his methods to other surgeons.

Click to view medical article. Warning, these are real patient photos and may be medically graphic.

• Mobley SR. (2004). Powered instrumentation for facial flap thinning. Ear Nose Throat J, 83(7), 460-461.
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  Mobley SR. (2004). Stretching the limits of full-thickness skin grafts. Ear Nose Throat J, 83(8), 526, 528.
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  16th Annual Chandler Society Resident and Fellow Research Forum