Severe and recurrent epistaxis in cases of Rendu-Osler-Weber's disease can be treated best by septal dermoplasty and intranasal skin grafting beyond the septum to include the upper lateral cartilage and interior turbinate as well as the floor of the anterior part of the nose. Combined with a large defect of the nasal septum the dermoplasty alone with the lining of the anterior part of the nose with split-thickness skin grafts is not without problems because of the excessive dryness and the severe and in part malodorous crusting of the nasal cavity. The necessary removal of the crustings can effect recurrent epistaxis. In this case, the reconstruction of the large septal defect with a frontotemporal flap is recommended. The temporal part of this pedicled forehead flap is taken from a region, which is only slightly affected by the teleangiectasias. Four weeks after the implantation of the frontotemporal flap into the septal defect the pedicle of the flap can be transected and removed. The functional result of this reconstruction of the nasal septum combined with the dermoplasty is satisfying.