The Expanded Forehead Flap for Nasal Reconstruction: A Systematic Review of Postoperative Outcomes in East Asian Patients

Introduction: The purpose of this systematic review is to assess postoperative outcomes of the expanded forehead flap (EFF) for nasal reconstruction in East Asian patients, focussing on both functional restoration and aesthetic satisfaction in a population with unique anatomical considerations. Methods: A systematic review was performed using PubMed, MEDLINE, Embase, and Scopus databases by 4 independent reviewers. Articles were included if they focussed on the use of an expanded forehead flap for nasal reconstruction in East Asian patients, with outcomes related to complications, aesthetic satisfaction, and functional results. Studies published in English between 1995 and 2025 were considered. Results: The literature search yielded 68 initial articles. After duplicates of articles were removed, 50 articles underwent title review. Thirty-six articles underwent screening, and 32 articles were approved for full-text review. Twelve studies were deemed appropriate for inclusion in the systematic review. Conclusion: The expanded forehead flap is an effective and reliable procedure for nasal reconstruction in East Asian populations, offering both functional and aesthetic improvements. However, complications such as colour mismatch, hypertrophic scarring, and flap vitality issues must be carefully managed. Further studies with standardized outcome measures can continue to refine surgical techniques and minimize complications, ensuring better long-term patient satisfaction.