Healing by Secondary Intention or Skin Grafting for the Paramedian Forehead Flap Donor Area.

Nasal reconstruction aims to restore both function and aesthetic integrity, with the nose being central to facial harmony. The paramedian forehead flap (PFF) is a cornerstone of nasal reconstruction due to its reliable vascular supply and excellent tissue match. Managing the PFF donor area, especially for larger defects, presents challenges, with secondary intention healing and skin grafting being common approaches. A 72-year-old male underwent nasal reconstruction with a PFF after basal cell carcinoma excision. The flap's donor area was managed with a skin graft. Years later, the patient developed a nasal squamous cell carcinoma requiring partial rhinectomy, followed by staged nasal reconstruction. The process included another PFF, providing an opportunity to compare two donor area management techniques: skin grafting and secondary intention healing. This case highlights the outcomes of both approaches, supported by a detailed photographic report documenting their differences in terms of aesthetics and patient satisfaction. This case provides insights into the optimal management of the PFF donor area. It allows a direct comparison between secondary intention healing and skin grafting, which are the conventional options, highlighting distinct outcomes in terms of aesthetics and patient satisfaction.