The radial forearm flap, applied as a free flap, has been shown to be very versatile, if covering a defect with a thin, flexible flap is of predominant importance. The advantage of this technique compensates for any disadvantages in the donor area. Under certain circumstances it is a better solution to design the radial forearm flap as a distant, vascular pedicled flap than to perform it as a free flap with microvascular anastomoses. In treatment of this patient we used a distally pedicled radial forearm flap to resurface a burned nose and to reconstruct the tip of the nose. In this case a scarred forehead prevented us from using an expanded forehead flap. The increased morbidity of a distant, pedicled flap was well accepted as the price for preventing additional scarring in the face, as would have occurred in the case of a free flap, through the exposure of vessels for the vascular anastomoses.