Reconstructing a complex central facial defect with a multiple-folding radial forearm flap.

The central face is the dominant feature of humans. A complex central facial defect can severely affect a person's appearance and function and can pose significant challenges for reconstructive surgeons. The aims and principles of central facial reconstruction are to achieve adequate function and esthetics. This report describes the case of a 45-year-old man who was bitten in the central face by a wild boar. A free radial forearm flap was designed as a multiple-folding flap that was divided into several portions. The folded portions of the flap were used to reconstruct the nasal mucosa, oral mucosa, and upper lip defects and provided the lining for an eventual staged nasal reconstruction. The patient achieved good functional recovery and had a good esthetic outcome.