| Summary: | Introduction: There are several options for forehead defect′s reconstructions, including different local flaps, regional flaps, free flaps and skin grafts. We used double opposing rectangular advancement flaps (H-flap) in the upper forehead defects. Materials and Methods: This is a prospective case series study that has done in Plastic surgery ward. Of the 10 patients, six were women and four were men, their median age was 61 years (range 50-79 years). Mean follow-up of patients were 15 months and there was no recurrence during this time. We reconstructed forehead after excision of tumours in the same operation. Results: Aesthetic results of H-flap in all cases were great with patient satisfaction according to questionnaire sheets. Conclusion: This local flap is a reliable and safe way for upper forehead defects up to 6 cm lengths. Long-term follow up showed inconspicuous scars and good texture and colour match of the reconstructed forehead. We recommend this flap for upper forehead reconstruction in defects between 4 cm and 6 cm. Directions of incisions are parallel to resting skin tension line and length to width of flap considered 2:1 with excision of burrow triangle from both side. We used silicon sheet post operatively for 3 months for better aesthetic results.
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