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

## TL;DR

A new surgical technique using a femoral condyle flap helps reconstruct nasal damage caused by long-term cocaine use.

## Contribution

The paper introduces the use of a medial femoral condyle free flap for nasal reconstruction in cocaine-induced midline destruction.

## Key findings

- The MFCFF provided effective nasal dorsum reconstruction with minimal donor site complications.
- Combining MFCFF with a paramedian forehead flap improved both function and aesthetics in long-term outcomes.

## 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.