Dermatoplasty for the treatment of epistaxis caused by HHT has become well established. A modification of Saunders' (1960) original dermatoplastic technique is described, which permits the nasolabial incision to be avoided. This retrospective study of the long-term effect on epistaxis caused by HHT demonstrates, in contrast to those with a short period of observation, that epistaxis can be partially controlled by means of dermatoplasty and, further, that it is impossible to eliminate completely the need for blood transfusion. In two of the patients it was found that newly formed telangiectases had occurred in the transplant 15 and 18 years post-operatively.