The forehead flap brings skin down from the forehead to rebuild larger defects of the nose, in planned stages. Carried out by Consultant Plastic Surgeon Miss Rakhee Nayar.
Women in the UK dual-trained in Mohs and plastic surgery
of 36 patients would recommend Miss Nayar (PHIN, September 2026)
A classic reconstruction
What is a Forehead Flap?
The paramedian forehead flap brings skin down from the centre of the forehead to rebuild the nose, staying attached to a narrow bridge of tissue that carries its blood supply from just above the inner eyebrow.
It is the oldest recorded reconstructive operation in surgery, and it is still the usual choice for rebuilding large defects of the nose.
Choosing the repair
When is a Forehead Flap Used?
Forehead skin is the closest available match to nasal skin in colour, thickness and texture, and the flap carries a strong blood supply.
That combination is why it is the technique most often chosen for substantial defects of the nose.
It asks more of the patient in time, and in how the nose looks between stages, which is why the decision is made carefully and together.
Large nasal defects
Large defects of the nose after Mohs surgery, particularly those involving the tip.
Several areas of the nose
Defects crossing more than one area of the nose.
Full-thickness defects
Full-thickness defects where lining, support and surface all need rebuilding.
When other repairs fall short
Cases where a nasolabial flap or a graft would not provide enough tissue.
Planned around you
A Staged Operation
The forehead flap is deliberately carried out in stages, usually two and sometimes three, spaced about three weeks apart.
The period when the bridge of tissue is still in place is the part most patients find hardest. It is temporary, and it is discussed fully with you beforehand.
Stage One
The flap is designed on the forehead, raised, rotated down and stitched into the nose. The forehead is closed directly.
Stage Two
About three weeks later, once the flap has its own blood supply from the nose, the bridge is divided and tidied.
Stage Three, If Needed
A later thinning and contouring procedure refines the shape.
Planned Together
Every stage is explained before you decide, so there are no surprises.
Clinical background
Why Choose Miss Rakhee Nayar for Your Reconstruction?
Reconstruction is where the result you live with is decided. With over 20 years of surgical experience, Miss Rakhee Nayar brings training in both skin cancer surgery and plastic surgery to the same operation.
One Surgeon, Start to Finish
Miss Nayar is one of fewer than 10 women in the UK dual-trained in both plastic surgery and Mohs micrographic surgery.
That means the surgeon who checks your margins under the microscope is the same one who plans and carries out the repair, knowing exactly what has been removed and why.
The Dual-Specialist Advantage
This combination means the person who removes your cancer is the same person who plans and carries out the repair. Miss Nayar is accredited as both a Consultant Plastic Surgeon and a Mohs surgeon.
- Cancer removal with every margin checked
- Repair chosen for your face and your wound
- One consultant from consultation to follow-up
- Plastic surgery training (FRCS Plast)
Training and Appointments
Miss Nayar is a Consultant Plastic Surgeon at Mersey and West Lancashire Teaching Hospitals NHS Trust, and sees private patients at Fairfield Independent Hospital and Circle Cheshire Clinic.
- She chairs the Mohs Surgery Training Interface Group (JCST), the national committee for Mohs fellowship training in the UK.
- She holds an MBChB with Honours and an MD from the School of Cancer Studies at the University of Liverpool.
- She is a Fellow of the Royal College of Surgeons of Edinburgh (FRCS Plast) and holds the European Board of Hand Surgery Diploma (EBHS).
- She is an active member of the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) and the British Medical Association.
Where it is used
Where Forehead Flaps Are Used
The forehead flap is used to rebuild the nose when a wound is too large for other repairs. See also Mohs surgery on the nose.
Read about the other reconstruction options: direct closure, healing by secondary intention, local flap, full-thickness skin graft, split skin graft and nasolabial flap.
The Nasal Tip
The Bridge of the Nose
The Side of the Nose
Full-Thickness Defects
Several Areas of the Nose
Request an e-Consultation
Miss Nayar offers a convenient e-Consultation service for patients seeking a specialist opinion from across the UK and overseas. This secure digital pathway enables remote assessment of skin lesions and concerns, providing a prompt clinical recommendation.
It is an ideal first step for those considering Mohs surgery or reconstruction before travelling for an in-person appointment.
Step by step
What the Procedure Involves
Most repairs are carried out under local anaesthetic on the same day as the Mohs surgery, once the microscope has confirmed the margins are clear. Each step is explained as it happens.
Years of surgical experience
Local anaesthetic
The area is numbed with local anaesthetic, and each stage is explained before it begins.
Designing the flap
Once the margins are clear, the flap is designed on the forehead using a template of the wound.
Raising and rotating
The flap is raised, rotated down and stitched into the nose, with its bridge of tissue left attached.
Closing the forehead
The forehead is closed directly, with any small area that cannot be closed left to heal naturally.
Dividing the bridge
About three weeks later, the bridge is divided in a second procedure, and a third refining stage is sometimes added.
Other options
Other Reconstruction Options
For smaller wounds on the nose, one of these repairs may be enough.
Nasolabial Flap
Cheek skin from beside the nose, used to rebuild the side of the nose. Read more
Local Flap
Neighbouring skin moved across on its own blood supply for a close match. Read more
Full-Thickness Skin Graft
Skin taken from a hidden donor site and laid into the wound. Read more
Healing by Secondary Intention
The wound is dressed and left to heal on its own, in the right sites. Read more
Healing week by week
Recovery and Healing
Recovery runs across the stages of the operation. Miss Rakhee Nayar gives you a clear plan for each stage and sees you between them.
- Weeks 1 to 3: swelling and bruising around the nose, forehead and eyes. The bridge of tissue is dressed and cared for daily.
- Week 3: the bridge is divided, with an immediate improvement in appearance.
- Weeks 4 to 12: swelling settles and the shape of the nose emerges.
- The forehead scar is red at this stage.
- Months 3 to 12: contour refines and scars pale.
- The vertical forehead scar typically fades to a fine line.
In Patients' Words
Patients Feedback
What Our Patients Say
Concerned About Skin Cancer?
Book a Specialist Assessment
Early assessment usually means a smaller operation and a simpler repair. Contact Miss Rakhee Nayar’s clinic for an assessment by a consultant dual-trained in Mohs and plastic surgery.
or Call Us Now
07740 306144
Circle cheshire Clinic
The Courtyard, Hall Ln, Wincham, Northwich CW9 6DG, United Kingdom
07740 306144
contact@mohssurgeon.co.uk
Schedule Your Visit
Where to See Miss Nayar
Miss Rakhee Nayar provides specialist Mohs and reconstructive surgery at Circle Health Cheshire Clinic. This modern, private facility offers expert care in a discreet environment for patients across Cheshire and the North West.
Frequently Asked Questions
We're Always Here to Help You
How long is the whole process?
Usually six weeks or more from the first stage to the second, and longer if a third refining stage is needed. Miss Nayar will give you a timeline before you decide.
What will I look like between stages?
The bridge of tissue is visible between the forehead and the nose for about three weeks. It is temporary, and most patients find it easier once they know exactly what to expect.
Will the forehead scar show?
The vertical scar on the forehead is red at first and typically fades to a fine line over the following months.
Will I be awake for the surgery?
Yes. Most repairs are carried out under local anaesthetic, so you stay awake and can talk to the team throughout. It also avoids the need for a general anaesthetic.
How long will it take?
It depends on how many Mohs layers are needed before the repair, which cannot be known in advance. Plan to be at the clinic for at least half a day.
Will it leave a scar?
All surgery leaves a scar. For large defects of the nose, a forehead flap restores both the surface and the three-dimensional shape, and the forehead scar usually fades to a fine line.