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CC BY 4.0 · Indian J Plast Surg
DOI: 10.1055/s-0045-1809054
Case Report

Medial Femoral Condyle Flap for Nasal Support in Cocaine-Induced Midline Destruction

Pedro Alvedro-Ruiz 
1   Department of Plastic and Reconstructive Surgery, University and Polytechnic Hospital La Fe, Valencia, Spain
,
Belén Andresen-Lorca
1   Department of Plastic and Reconstructive Surgery, University and Polytechnic Hospital La Fe, Valencia, Spain
,
Iván Heredia-Alcalde
1   Department of Plastic and Reconstructive Surgery, University and Polytechnic Hospital La Fe, Valencia, Spain
,
Alessandro Thione
1   Department of Plastic and Reconstructive Surgery, University and Polytechnic Hospital La Fe, Valencia, Spain
,
María Dolores Pérez-del-Caz
1   Department of Plastic and Reconstructive Surgery, University and Polytechnic Hospital La Fe, Valencia, Spain
,
Alberto Pérez-García
1   Department of Plastic and Reconstructive Surgery, University and Polytechnic Hospital La Fe, Valencia, Spain
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Abstract

Prolonged cocaine use can severely damage the osteocartilaginous structures of the midface region. Involvement of the nose, sinuses, and palate has been grouped into a syndrome called cocaine-induced midline destructive lesions. These lesions may resemble other necrotizing conditions, often complicating diagnosis and treatment. A complex nasal reconstruction is introduced in a 54-year-old woman with extensive midfacial destruction after 15 years of cocaine abuse. Total nasal reconstruction was performed using a medial femoral condyle free flap (MFCFF) for internal lining and bone support in combination with a paramedian forehead flap for external coverage. The MFCFF proved to be effective in recreating the anatomy of the nasal dorsum with minimal donor site morbidity, while the paramedian forehead flap improved the aesthetic results. Despite the need for multiple surgical interventions, this approach showed satisfactory functional and aesthetic long-term results.

Keywords

medial femoral condyle flap - nasal reconstruction - cocaine


Publication History

Article published online:
13 May 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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